If you're a chiropractor in Portland stuck at 40-70 Google reviews while your competitor down the street has 300+, you already know what's happening: they're showing up higher in search, getting more new patients, and you're bleeding opportunities.
Every time someone searches "chiropractor near me" in Beaverton or "back pain relief Portland," your competitor's name shows up first. Yours is buried on page two. You know you're just as good—probably better—but it doesn't matter. They're visible. You're not.
The calls that should be coming to your practice are going to them instead. And it's not slowing down. Each month they pull further ahead while you're still asking your front desk to "remember to hand out review cards" or sending emails that nobody opens.
The difference isn't their marketing budget. It's automation.
They figured out how to generate reviews at scale without lifting a finger. While you're manually asking patients (and forgetting half the time), they have a system running 24/7 that never misses an opportunity.
Here's how practices are generating 50+ authentic reviews per month without their staff doing anything.
How the System Actually Works
Your practice management software (ChiroTouch, Jane App, Cliniko, PT Everywhere) connects to GoHighLevel through an API. When you mark a patient's appointment as complete, the review automation fires.
Here's the sequence:
1-2 day after their visit, the patient gets a text:
"Hi Samantha this is Dr. Jenny with JenChiro!
It was a pleasure helping you! 😊
Just a quick check in, how many stars would you rate your visit with us?
5 being great, and 1 not so great.
Your feedback means the world to us!"
If they respond positively, they get a follow-up:
Thanks so much, Samantha! 🙌
We're so glad you had a great experience with us!
If you’re open to it, would you mind sharing your experience on Google too? It helps us out so much!
Here's our link in case you want too: [your google review link]
We're truly grateful for you.
If they respond negatively, you get an internal notification via text message. The patient gets:
"Thank you for your feedback, Samantha. We really appreciate you taking the time to share this with us. We've passed this along to our team so we can address it."
That's it. No front desk remembering to ask. No email blasts that get ignored. Just a text at the right time with their name and their doctor's name.
PS. These automations don’t send “bulk texts.” Every message is written and delivered as if you’re texting one patient at a time. It always greets them by their first name, pulled directly from their contact record, so it feels personal, intentional, and human.
The Two-Step Filter (This is Critical)
Most practices screw this up by sending every patient straight to Google. Bad idea.
We use a two-step filter:
Step 1: Ask how their visit went. No pressure. Just "How'd it go?"
Step 2A: Positive response → Send Google review link
Step 2B: Negative response → Send internal feedback + notify staff immediately
This does three things:
- Only happy patients leave public reviews
- Unhappy patients get handled before they trash you online
- You get real-time alerts when something goes wrong
One of our Portland clients had a patient complain about wait time. Front desk called them within 20 minutes, offered a free follow-up visit. Patient never left a bad review.
But here's the real point: this isn't about gatekeeping your Google reviews. It's about listening to patient feedback and showing up for them even after they've left your clinic.
The goal is to make sure you're informed about every patient's experience. If someone had a negative visit, the system gives you a chance to catch it, address it, and make it right before they walk away forever.
At the same time, it gives you feedback as the owner. You can see where your staff is falling short. Maybe one chiropractor consistently gets complaints about being rushed. Maybe your front desk is booking appointments too tightly. Maybe patients hate waiting 20 minutes past their scheduled time.
Now you can actually do something about it. Have a conversation with your team. Adjust scheduling. Train staff on better communication. Fix the root problem instead of just hoping bad reviews don't show up.
The positive reviews flowing in every month? That's the cherry on top. The real value is having a system that captures feedback while you still have a chance to do something about it.
Most clinics think this is about protecting their Google rating. It’s actually about catching problems while patients still care.
You win when feedback reaches you fast enough to fix the experience — not after the review is already public.
Which CRMs Actually Work (and Which Don't)
We've integrated this with dozens of practice management systems. Some are plug-and-play. Others make us want to pull our hair out.
Here's how it works technically: we connect to your practice software's API, pull specific patient data (first name, last name, phone, email, and appointment status), and send it to GoHighLevel. GHL is our front-end CRM that handles all the communication. It's HIPAA compliant, and we only grab the minimum data needed to trigger the automations—no health records, no treatment notes, nothing sensitive.
From there, we set up an A2P verified phone number that matches your city. So if you're in Beaverton, texts come from a Beaverton number. Portland practice? Portland number. Makes it feel local and legitimate, not like spam from a random area code.
Some of the Easy integrations are:
- ChiroTouch
- Jane App
- Cliniko
- PT Everywhere
- SimplePractice
These have clean APIs and good documentation. Setup takes a day or two, rarely any issues.
These are harder but doable:
- Kareo
- athenaOne
- AdvancedMD
These work, but their APIs are clunky. Sometimes data doesn't sync perfectly the first time. We usually get them running within a week, but expect a few back-and-forth troubleshooting calls.
Basically impossible:
- Fully custom/proprietary systems with no API
- Super old legacy software that hasn't been updated since 2010
If your system has no way to send data out automatically, we can still make it work—but it requires manual export/import. Meaning your staff has to upload a patient list weekly. Defeats the purpose of automation.
Bottom line: if your software has an API or webhooks, we can connect it. If it doesn't, you might want to consider switching systems anyway. Most old platforms are killing your efficiency in other ways too.
Local rankings are decided long before patients choose where to click.
Our free SEO ebook explains the signals Google looks at — and where most clinics waste time.
What You're Actually Getting (It's Not Just Reviews)
The review automation is part of our Pulse Minimum plan. Here's everything included:
- GoHighLevel CRM - Your entire patient communication hub
- Review automation - The system we just described
- AI chatbot - Answers questions on your website 24/7
- Google Business Profile optimization - We clean up your GBP and keep it updated
- Automated review replies - We respond to every Google review for you
It's not a "review tool." It's your whole patient communication system built specifically for healthcare practices.
Setup takes about a week. A2P registration for SMS compliance, API integration with your practice software, chatbot install on your site, GBP cleanup.
Then it runs on its own.
Real Numbers from a Portland Client
One of our Beaverton clients (anonymized for privacy):
Before:
- 82 total Google reviews
- Getting 3-5 new reviews per month
- Ranked #7 for "chiropractor Beaverton"
After 6 months:
- 312 total Google reviews
- Averaging 52 new reviews per month
- Jumped to #2 for "chiropractor Beaverton"
- New patient calls increased 38%
The owner told us: "I don't even think about reviews anymore. They just show up. My front desk used to try to remember to ask—now they don't have to. It's completely automatic."
Their response rate is about 18%. Meaning if they see 300 patients in a month, roughly 54 leave reviews. Not everyone responds to the text, but enough do that it compounds fast.
Want to see more examples? Check out our client case studies.
Who This Isn't For
Be honest with yourself. This system isn't for every practice.
Don't do this if:
- You're seeing fewer than 100 patients per month (the math won't get you to 50 reviews)
- You're using ancient software with no API and refuse to switch
- You want to "test it out" for a month (it takes 2-3 months to build momentum)
But here's the thing about inconsistent patient satisfaction:
If your patients are leaving unhappy often, this system will expose it fast. And that's not a bad thing—it's actually the most valuable part.
Remember, the system doesn't send a Google review link to everyone. It filters. Unhappy patients get caught before they go public. What you get instead is real-time feedback showing you exactly what's broken.
Maybe your wait times are too long. Maybe one chiropractor is rushing through appointments. Maybe your front desk is rude on the phone. Whatever it is, you'll know within days instead of months.
At that point, the goal isn't to expect positive reviews—it's to fix the foundation first. And you're not doing it alone. You work directly with a chiropractic specialist on our team (we have staff who've literally run chiro clinics before joining us). They've seen enough successful practices to know what good operations look like.
Once the leaks are fixed, then the reviews start flowing. But business is never static. It's almost never black and white. The goal isn't always to blow up your practice overnight—it's to fix the leaks first, then scale what's working.
Do this if:
- You're seeing 150+ patients per month
- Your patients generally leave happy (or you're willing to fix what's broken)
- You're tired of competitors outranking you purely because they have more reviews
- You want the system to run itself without staff involvement
If you're on the fence, look at your closest competitor's Google reviews. If they have 200+ and you have under 100, you're already behind. Every month you wait, the gap gets worse.
The Portland Market Reality
Portland's chiropractic market is saturated. There are practices in every neighborhood—Hawthorne, Beaverton, Lake Oswego, Hillsboro, Southeast, Northwest, you name it.
Patients don't browse. They search "chiropractor near me" and pick from the top 3 results. If you're not in that top 3, you don't exist.
Google's algorithm weights review quantity, review recency, and review velocity heavily for local rankings. A practice with 300 reviews getting 50/month will beat a practice with 150 reviews getting 5/month—even if the second practice has better ratings.
Here's what that looks like in real terms: if you're ranked #4 or lower on Google Maps, you're getting maybe 10-15% of the search traffic that the #1 spot gets. The drop-off is brutal. Most people never scroll past the top three.
And it compounds. The practice in the #1 spot gets more clicks, which signals to Google that they're more relevant, which keeps them in the #1 spot. More visibility means more patients, which means more opportunities for reviews, which means even higher rankings. It's a flywheel that's almost impossible to break into once someone else has it spinning.
Your competitors who figured this out two years ago? They're not slowing down. They're adding 40-60 reviews per month while you're adding 3-5. The gap doesn't stay the same—it gets wider every single month.
You're not competing on quality of care anymore. You're competing on visibility. And visibility is a function of reviews + AI-powered SEO. You can be the best chiropractor in Portland, but if no one can find you, it doesn't matter.
How to Actually Get Started
If you want this running in your practice, here's the process:
Step 1: Book a 15-minute call
We'll show you how it works with your specific practice software and patient volume. Not a sales pitch—we're literally showing you the system, walking through what the texts look like, how the filter works, and what to expect based on how many patients you see per month.
If your setup is complicated (weird CRM, multi-location, custom workflows), we'll tell you upfront what's involved.
Step 2: Onboarding starts immediately
If you move forward, we kick off the build. A2P registration for SMS compliance, API integration with your practice software, GoHighLevel setup, AI chatbot install on your website, Google Business Profile optimization.
You'll get assigned a chiro specialist from our team. They'll walk you through what we need from you (API credentials, GBP login, any custom preferences for messaging). Most of this happens in one or two calls.
Step 3: You're live within a week
Review requests start going out automatically after every appointment. The AI chatbot is answering questions on your site. Google review replies are being handled. You'll get a dashboard login so you can see everything happening in real-time, but you don't need to touch it.
Step 4: You do nothing
Reviews come in. Chatbot handles site visitors. Google replies are managed. Negative feedback gets routed to you before it becomes a public problem. The system runs on its own.
We don't do contracts. If it stops working or you hate it, you can cancel anytime. But most clients stay because once you see 50 reviews roll in the first month without lifting a finger, you're not going back to manual requests.
And if things aren't working—response rates are low, patients aren't clicking through, whatever—we adjust. Tweak the message timing, rewrite the copy, add filters. We're not set-it-and-forget-it. We actively manage it until it's hitting the numbers you need.
Schedule a demo here or check out our full review automation breakdown.
FAQ
How long until I see results?
First reviews usually come in within 24-48 hours of going live. You'll hit your stride by week 2-3 once the system has processed a full cycle of patients.
What if I get a negative review?
The filter catches most of them before they go public. If one slips through, we respond on your behalf within 24 hours with a professional, empathetic reply.
Does this work for multi-location practices?
Yes. We've set this up for practices with 2-50+ locations. Each location gets its own automation flow tied to its specific GBP.
Can I customize the message templates?
Completely. We build the initial templates based on what converts best, but you can adjust tone, timing, and wording anytime.
What's the monthly cost?
Pulse Minimum (which includes everything listed here) starts at $697/month and a 1 time setup of $1000. No contracts.
Is this compliant with Google's review policies?
Yes. We're not buying reviews or incentivizing them. We're just asking at the right time with a direct link. That's explicitly allowed under Google's guidelines.
What if my practice software isn't listed here?
Book a call. If your software has an API, we can probably integrate it. We've worked with systems not listed here—just takes a bit more custom work.
Should I also optimize for voice search?
Yes. Voice search is huge for chiropractors. Read our guide on optimizing for voice search to see how it works with review automation.
About Local Pulse Marketing
We're Portland's AI marketing agency for chiropractors, med spas, dentists, and home service companies. We build automated systems that generate leads, reviews, and revenue without adding work to your plate.
Want to see what else we do? Check out our case studies or learn about our AI-powered local SEO.
The clinics that win aren’t chasing stars or begging patients for feedback. They’ve built simple systems that listen first, respond fast, and improve the experience before it turns into a public complaint. When feedback flows consistently, reviews follow naturally — and so do rankings.
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