Resilience Orthopedics is a solo, cash-pay practice. No hospital system behind it, no insurance contracts feeding the diary. Dr Pamela Mehta started with referrals and word of mouth; growing meant being found, trusted and chosen by patients who had never heard her name. That is what she hired us to do in 2022, and she has been a client longer than anyone else.
2022: the build
When she came to us in early 2022, the website drew between five and twenty visits a day from search (Google Analytics). We rebuilt it, organised every service page so that a patient, Google and an AI could all tell exactly what she treats, and published the health information her patients were already searching for, written and checked to a medical standard.
By February 2025 the same site was drawing 3,500 to 5,000 visits a day from search. Since 2022 it has brought in more than 2.5 million visits that way: four of every five visits the practice's website has ever received.
Two slower things were building underneath: reviews, folded into the front desk's routine rather than run as a campaign, and a steady press programme that has Dr Mehta quoted in TIME, Forbes, National Geographic, Medical News Today and more than thirty other publications. Neither builds quickly, and both turn out to matter later in this story.
2024: when AI Overviews arrived
In 2024, Google started answering questions itself. Search "how do I sleep with shoulder pain" and an AI-written answer now sits above the results, so most people never click through to anyone.
Google's own Search Console shows what that did to the site. Between March 2023 and June 2024 it averaged position 12.6, and 2.9% of searchers clicked through to it. Over the sixteen months to August 2026 its average position improved to 9, the best it has ever been, yet only 1.6% of searchers clicked anything. The site was ranking better than ever and being visited less.
Roughly 30% of traffic and enquiries disappeared. The chart looked worse than the reality. Most of the lost visits were people reading, not people booking: the information pages had been drawing thousands of readers a day, and those were the visits AI answers removed. The visits that become patients, people in and around San Jose searching for care, slipped from about 100 a day to about 65. The lost readers cost the practice nothing, but a third of the bookable visits was a real loss, and that is the number the new plan was built to recover.
So we changed the plan. The writing budget moved from information pages to the pages patients book from, starting with her highest-value procedures, each one rewritten around what a person choosing a surgeon needs to know rather than the anatomy of the joint. The review push was rebuilt, and the quiet technical work that helps Google and AI read the site carried on. The ads budget went up to carry the practice while search recovered, because SEO is slow and a diary cannot wait for it. The ads run with a partner agency; we build every page they land on, and both channels answer to one budget. Six months on, in Dr Mehta's words: a full clinic again, for the first time in six months.
2026: where she stands in AI answers
Every day we put the same 50 questions to ChatGPT and Google's AI Overviews, the questions her patients actually ask: "find me an orthopedic surgeon near Los Gatos", "where can I get PRP injections in San Jose". None of the questions mention her by name, and a third of the answers recommend her anyway.
Over the 30 days to 26 August 2026, that tracking covered 801 answers (Peec AI):
- When an answer does recommend her, she appears near the top of the list, at position 2.3 on average.
- Across those questions, her own website is the source these AIs open most often when they build an answer, ahead of every hospital system and health publisher in the sample.
Limitations
- We chose the prompts, around her services and her areas. The sample is built to represent her ideal patient, which also means it flatters her.
- We only measure ChatGPT and Google's AI Overviews, not Perplexity, Claude or the rest.
- AI answers change from run to run. Treat every figure as directional, not as market share.
The map
What someone sees when they search "orthopedic surgeon in San Jose" depends on where they are standing, so we check her map rankings every week from 81 points spread across the whole city, not from one office address. As of 26 August 2026 she averages 4th across all of them, and holds the top 3 across the southern half of the city, where her patients are.
What keeps a clinic at the top of the map is reviews: 312 at 4.7 stars as of 28 August 2026, across Google, Yelp, Vitals, Healthgrades and RateMDs, 173 of them on Google. All of them earned at the front desk, never bought and never gated.
What it adds up to
Fewer than ten enquiries a month reached the practice when we started. In August 2026 it is around 300: roughly 100 from search, 100 from her Google profile, 20 from people coming straight to the site, and 80 from the ads, counted in the practice's own enquiry system. Every one gets an automatic, immediate reply and a fast call back, because an enquirer reached within five minutes rather than thirty is 21× more likely to turn into a real conversation.
Why it worked
Five things did the work, and none of them were quick:
- A technically clean website with its information laid out so patients and AI can read it.
- The who, what, where and how of every service stated plainly, on the page.
- Press earned steadily over years, not in one push.
- A founder who shows up: podcasts, board roles, an active following. We amplify that; we could not have invented it.
- A reputation patients wrote themselves, review by review.
None of it works on a short timescale. It compounded over four years, and those four years are why AI answers trust her now: AI recommends whoever the web already agrees on.
How we work with Resilience
Resilience is a partner engagement: the SEO and AI search, the ads alongside a partner agency, the website itself, and the systems that catch and follow up every enquiry. One team and one budget, pointed at booked patients.