Someone searches medical weight loss in your town. The top three listings show before-and-after photos, a number in the headline, and a countdown offer. Yours shows an address, a category, and a post from last spring. You are the one with a physician on site and you look like the least serious option on the screen.
The part that grates is that you are being careful on purpose. You will not publish an average pound figure, you will not run a photo grid, and you will not promise anyone anything, because you know what the FTC does about weight-loss claims and you would like to keep your licence. Restraint is the right call and it is currently costing you the search.
So enquiries come from the same two referral sources and word of mouth, and consultation slots go unbooked in the months after January when demand across the whole category is highest. Your fixed costs do not move with the calendar.
And the person who booked with the countdown-offer clinic may well be back in your waiting room in a year, having paid someone else first for something that did not suit her.