Welcome everyone to Episode #65 of the Chiropractic Marketing Podcast.
I’m your host, Dr. Patrick MacNamara, and today we’re going to explore something that might hit a little close to home for some of you. We’re going to talk about a classic business parable that I believe perfectly captures what’s happening right now in the world of chiropractic marketing and why so many practices are struggling to adapt to the massive changes we’re seeing with AI search and generative engine optimization.
You’ve probably heard of the book “Who Moved My Cheese?” by Dr. Spencer Johnson. If you haven’t read it, don’t worry, I’m going to walk you through it today because the lessons in this simple little story are more relevant now than ever before, especially when it comes to how chiropractors need to think about their marketing strategies in this AI-driven world we’re living in.
Now, before we dive in, let me tell you why I decided to dedicate an entire episode to this topic. Over the past few months, I’ve had countless conversations with chiropractors who are frustrated, confused, and frankly scared about what’s happening with their online visibility. They tell me things like “I used to rank number one on Google, but now I’m nowhere to be found” or “I’ve been doing the same SEO tactics for years and they just stopped working” or my personal favorite, “This AI stuff is just a fad, right? Things will go back to normal soon?”
And that last one, that’s the one that really worries me. Because it tells me that some chiropractors are waiting for the world to go back to the way it was, and I’ve got to be honest with you, that’s not going to happen. The cheese has moved, my friends, and if we don’t move with it, we’re going to be left behind.
So let’s start with the story itself. “Who Moved My Cheese?” is a deceptively simple parable about four characters who live in a maze and spend their days looking for cheese, which represents whatever makes you happy in life. Could be success, could be money, could be patients walking through your door every single day. For our purposes today, let’s say the cheese represents new patients and the visibility that brings them to your practice.
The four characters are two mice named Sniff and Scurry, and two little people named Hem and Haw. Now these characters represent different approaches to change, and I want you to think about which one you might be as I describe them.
Sniff is the mouse who sniffs out change early. He’s always paying attention to what’s happening around him, noticing when things start to shift. Scurry is the other mouse, and once Sniff identifies that change is coming, Scurry immediately takes action. He doesn’t overthink it, he just adapts and moves forward.
Then we have Hem and Haw, the two little people who represent the more complex human response to change. Hem is resistant to change. He gets angry when things shift. He complains, he denies reality, and he refuses to adapt because he’s comfortable with the way things are. Haw starts out just like Hem, resistant and scared, but eventually, he realizes that if he doesn’t change, he’s going to starve. So he overcomes his fear and ventures out into the maze to find new cheese.
In the story, all four characters find a huge pile of cheese at Cheese Station C, and they get comfortable. They build their routines around this cheese. They expect it to be there every day. But here’s the thing, the cheese doesn’t last forever. It starts to get smaller and smaller, but Hem and Haw don’t notice because they’re not paying attention. They just assume the cheese will always be there.
One day, they show up and the cheese is completely gone. The mice, Sniff and Scurry, saw this coming. They noticed the cheese getting smaller, so they already ventured out into the maze and found Cheese Station N with a fresh supply. But Hem and Haw? They’re shocked, angry, and in denial. They keep going back to Cheese Station C day after day, hoping the cheese will magically reappear.
Now, I want you to think about how perfectly this mirrors what’s happening in chiropractic marketing right now. Traditional SEO, the kind that’s been working for the past decade or more, that was your Cheese Station C. It was reliable, it was comfortable, and if you did the right things like optimizing your website, building some backlinks, and maybe posting a blog here and there, you could count on Google to send you a steady stream of new patients.
But here’s what a lot of chiropractors missed. The cheese started getting smaller years ago. Google’s algorithm updates kept changing the rules. The rise of mobile search changed how people looked for chiropractors. Voice search started becoming more popular. And then, the big one, AI search engines and tools like ChatGPT, Perplexity, and Google’s AI Overviews completely transformed how people find and choose healthcare providers.
The writing was on the wall, just like in the book. But so many practices kept doing the same things they’d always done, expecting the same results. And now they’re wondering where all their patients went.
Let me paint you a picture of what this looks like in real terms. A few months ago, I talked with a chiropractor who had been ranking in the top three results for “chiropractor in” his city for five years straight. He was getting about thirty new patient calls a month just from his website. He wasn’t paying much attention to his Google Business Profile, he hadn’t updated his website content in two years, and he certainly wasn’t thinking about how AI might impact his practice.
Then, seemingly overnight, his calls dropped by more than half. When I looked at his analytics, I could see exactly what happened. His traditional search rankings had slipped, but more importantly, he wasn’t showing up in any AI-generated recommendations. When someone asked ChatGPT or Perplexity for chiropractor recommendations in his area, his practice was invisible. When Google’s AI Overviews displayed information about local chiropractors, he wasn’t there. The cheese had moved, and he hadn’t moved with it.
This is where the story gets really interesting, because in the book, Hem and Haw react very differently to discovering the cheese is gone. Hem gets angry and bitter. He keeps asking “Who moved my cheese?” He feels entitled to the cheese, like someone owes it to him. He refuses to accept that the world has changed and spends his time complaining instead of adapting.
Does this sound familiar? I hear it all the time in our industry. “Google is unfair.” “These AI companies are ruining everything.” “It’s not right that I have to change my entire marketing strategy.” And look, I get it. Change is hard, especially when you’ve invested time and money into strategies that used to work. But here’s the harsh reality, complaining about change doesn’t bring the cheese back.
Haw, on the other hand, eventually realizes that he has two choices. He can stay at Cheese Station C and starve, or he can face his fear and go find new cheese. It’s not an easy decision. He’s scared. He doesn’t know what’s out there in the maze. But eventually, he writes a message on the wall that changes everything. He writes, “If you do not change, you can become extinct.”
That message, right there, is what every chiropractor needs to understand about this AI revolution we’re experiencing. Traditional SEO isn’t coming back. AI search isn’t going away. The patients who are searching for chiropractors today are increasingly using AI tools to make their decisions, and if you’re not visible in those AI results, you might as well not exist.
Now, as Haw ventures out into the maze, he learns several important lessons, and I want to connect each of these to what chiropractors need to understand about adapting to this new reality.
First, Haw realizes that the cheese he’d been eating at Cheese Station C wasn’t actually that fresh anymore. It had been slowly deteriorating, but he’d gotten so used to it that he didn’t notice. He writes on the wall, “The quicker you let go of old cheese, the sooner you find new cheese.”
Think about your traditional SEO strategies for a moment. How long have you been doing the same things? Are you still focused primarily on your website rankings while ignoring your Google Business Profile? Are you still writing blog posts the same way you did five years ago without thinking about how AI will interpret and recommend your content? Are you still measuring success solely by website traffic instead of looking at whether you’re showing up in AI-generated recommendations?
The truth is, many chiropractors are clinging to old cheese that’s gone stale, and they don’t even realize it. I see practices spending thousands of dollars on traditional SEO services that focus almost entirely on website optimization while completely ignoring generative engine optimization and the signals that AI systems use to make recommendations.
The second lesson Haw learns is that change doesn’t have to be scary once you embrace it. In fact, he starts to enjoy the adventure of exploring the maze. He writes, “When you move beyond your fear, you feel free.” And this is something I see with the practices that are thriving right now. Once they stop resisting the changes happening in search and start leaning into strategies like AI visibility optimization and search everywhere optimization, they realize it’s actually exciting.
These new strategies open up opportunities that never existed before. When someone asks an AI assistant for a chiropractor recommendation and your practice is the one that gets recommended with specific details about how you can help them, that’s powerful in a way that a traditional Google ranking never was. When your practice shows up in Google’s AI Overviews with authoritative information about specific conditions you treat, you’re not just visible, you’re positioned as the expert.
The third lesson, and this is crucial, is that you have to keep monitoring the situation. Haw learns that he can’t just find new cheese and assume it’ll be there forever. He needs to stay alert, notice when things are changing, and be ready to adapt again. He writes, “Smell the cheese often so you know when it is getting old.”
This is where so many chiropractors make the same mistake twice. Let’s say you’re one of the smart ones who recognized early that AI search was going to change everything. Maybe you started optimizing your Google Business Profile, you created content that’s AI-friendly, and you saw great results. That’s fantastic. But here’s the thing, the AI landscape is still evolving rapidly. The signals that matter today might be different six months from now. The platforms patients use to search might shift. New AI tools might emerge that change the game again.
You can’t optimize once and then forget about it. You need to be like Sniff, constantly monitoring what’s happening, noticing the trends, watching where patients are going to find their healthcare providers. And when you see change coming, you need to be like Scurry and take immediate action.
Now let’s talk about what the “new cheese” actually looks like for chiropractors in today’s world. If traditional SEO was Cheese Station C, then the combination of local SEO, AI optimization, and generative engine optimization is Cheese Station N. But unlike the old cheese, this new cheese requires a more sophisticated approach.
First, you need to master your local presence. I talk about this all the time, but your Google Business Profile is now more critical than it’s ever been. AI systems pull heavily from local search data when making recommendations. If your profile isn’t complete, if you’re not posting regularly, if you’re not actively managing reviews, you’re essentially invisible to AI search tools.
I worked with a practice last month that had decent traditional SEO but a neglected Google Business Profile. We spent ninety days focusing exclusively on their local presence, implementing the strategies I teach about in my Google Business Profile optimization episodes. Within that time frame, they started appearing in AI-generated recommendations, their map rankings improved dramatically, and their new patient calls increased by sixty percent. Sixty percent. Just from focusing on that foundational local presence.
Second, you need to understand that AI doesn’t evaluate your practice the same way traditional search engines do. Google’s traditional algorithm looks at things like keywords, backlinks, and technical SEO factors. AI systems look at your reputation, your expertise signals, the comprehensiveness of your information, and how well you match specific patient needs.
This is where generative engine optimization comes in. It’s not just about ranking for keywords anymore. It’s about being the practice that AI confidently recommends when someone asks for help with a specific condition. It’s about having the kind of authoritative, comprehensive content that AI systems trust. It’s about building genuine expertise signals across multiple platforms.
Third, you need to embrace what I call search everywhere optimization. Patients aren’t just using Google anymore. They’re asking ChatGPT for recommendations. They’re using Perplexity to research conditions. They’re turning to Claude or other AI assistants for healthcare advice. Each of these platforms evaluates and recommends practices differently, and if you’re only optimized for traditional Google search, you’re missing the majority of potential patients.
Now, I know what some of you are thinking. “Dr. Mac, this sounds overwhelming. I’m already busy running my practice. How am I supposed to keep up with all these changes?” And you’re right, it is overwhelming if you try to do everything at once. But remember what Haw learned in the maze. You don’t have to change everything overnight. You just have to start moving in the right direction.
This is exactly why I developed the tiered approach to local SEO that I’ve talked about in previous episodes. You don’t jump straight to advanced AI optimization if you haven’t mastered your basic local presence. You build systematically, tier by tier, just like Haw explored the maze step by step.
If you’re still struggling with basic visibility in local map results, that’s Tier 1, and that’s where all your focus should be. Master your Google Business Profile management, get consistent reviews, post regular content, and dominate your local map pack. Once that foundation is solid, then you can move to Tier 2 and start optimizing your website more comprehensively.
And when you’ve mastered both your local presence and your website optimization, that’s when you’re ready for Tier 3, where we focus on AI visibility, comprehensive authority building, and becoming the obvious choice not just in Google search but across all the platforms where patients are making decisions.
Let me share one more story from a practice I’m working with right now because I think it perfectly illustrates the difference between being Hem and being Haw. This chiropractor called me six months ago, frustrated and angry. He’d been in practice for fifteen years, had always gotten steady new patients from his website, and suddenly his phone stopped ringing. His first reaction was pure Hem. “Google changed their algorithm to hurt small businesses.” “These AI companies are destroying my livelihood.” “Someone needs to do something about this.”
I let him vent, because sometimes you need to, but then I asked him a simple question. “Do you want to be right, or do you want to get more patients?” That stopped him in his tracks. Because at the end of the day, it doesn’t matter if we think the changes are fair or unfair. What matters is adapting to reality.
We started with his local presence, which had been completely neglected. Within thirty days, we had his Google Business Profile optimized and active. Within sixty days, he was back in the top three map results for his main keywords. Within ninety days, he started showing up in AI-generated recommendations. And today, six months later, he’s getting more new patients than he ever did with his old traditional SEO approach.
But here’s what really transformed for him. It wasn’t just that his marketing improved. It was his entire mindset about change. He went from being resistant and bitter to being curious and proactive. Now he’s the one asking me about emerging trends. He’s the one experimenting with new content formats. He’s the one who wants to be ahead of the curve instead of constantly playing catch-up.
He transformed from Hem to Haw, and eventually into someone more like Sniff and Scurry, always watching for changes and ready to adapt quickly. And that mindset shift is worth more than any specific marketing tactic because it means he’ll be able to navigate whatever changes come next.
There’s one more message Haw writes on the wall that I want to leave you with today. He writes, “Old beliefs do not lead you to new cheese.” Think about the beliefs you might be holding onto about marketing, about how patients find chiropractors, about what it takes to be successful. If those beliefs were formed five or ten years ago, before AI search existed, before generative engine optimization was a thing, before patients were asking ChatGPT for healthcare recommendations, then those beliefs might be exactly what’s holding you back.
You might believe that having a nice-looking website is enough. You might believe that ranking on page one of Google is the ultimate goal. You might believe that SEO is something you do once and then you’re done. All of those beliefs were reasonable in the old world of Cheese Station C. But they don’t lead to new cheese. They keep you stuck exactly where you are.
The practices that are thriving right now, the ones that are growing their patient base month after month, they’ve adopted new beliefs. They believe that adaptation is ongoing, not a one-time event. They believe that AI visibility is just as important as traditional search visibility. They believe that their local presence is the foundation everything else builds on. And they believe that investing in their online presence isn’t optional, it’s essential.
So here’s what I want you to do after this episode. First, honestly assess which character you’ve been. Have you been like Sniff, noticing the changes early and staying informed? Have you been like Scurry, taking quick action when you see changes happening? Or have you been like Hem, resisting change and hoping things go back to the way they were? Or maybe you’re Haw, someone who resisted at first but is now ready to venture out and find new cheese?
Second, I want you to write your own message on the wall. What’s the one thing you need to accept or let go of to move forward? Maybe it’s the belief that you don’t need to worry about AI. Maybe it’s the idea that your traditional SEO is good enough. Maybe it’s the fear that you can’t figure out these new strategies. Write it down, acknowledge it, and then commit to moving past it.
Third, take one concrete action this week toward finding your new cheese. If your Google Business Profile isn’t fully optimized, start there. If you haven’t looked at whether you’re showing up in AI-generated recommendations, do a search and find out. If you’re not sure where to start, visit dcrank.com and let’s have a conversation about what your practice needs most right now.
The cheese has moved, there’s no doubt about that. But unlike the story, you’re not alone in the maze. You have resources, you have support, and you have proven strategies that work in this new AI-driven world. The question is, are you going to stay at Cheese Station C waiting for cheese that’s never coming back, or are you going to venture out and find the abundant new cheese that’s waiting for you at Cheese Station N?
I’ve worked with many solid and successful practices through this transition, and I can tell you with absolute certainty that the chiropractors who adapt thrive. They don’t just survive the changes, they actually end up in a better position than they were before because they’re reaching patients who never would have found them through traditional search alone.
The future of chiropractic marketing is incredibly bright if you’re willing to embrace it. AI search isn’t the enemy, it’s an opportunity. Generative engine optimization isn’t something to fear, it’s a chance to position yourself as the obvious expert choice. And the changes happening right now aren’t the end of effective marketing, they’re the beginning of a new era where practices that adapt can dominate their markets like never before.
So let’s move beyond our fear, let’s let go of the old cheese, and let’s go find the new cheese together. Because I promise you, it’s out there, it’s abundant, and it’s fresher and better than what we had before.
Alright, that wraps things up for today’s episode.
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