What Is AEO?

A patient who wants lip filler used to type a few words into Google and scroll through a list of links. Increasingly, patients ask a question in a full sentence and get back a written answer. That answer names a handful of practices. If yours is one of them, you are in the conversation. If it is not, a competitor is.

Each answer recommends one practice first, with a reason such as its rating or its services, and offers others as further options, which are also recommended. The numbered markers are citations. Some point to directories and review sites, and some to a practice's own website, and a business whose page is among them is cited as a source, whether or not the text names it. The third way, named in passing, is a business that appears without being offered as a choice, for example when the answer credits it with a fact. These four answers do not show it. Each of the three is its own result with its own fix.

AEO in Plain Terms

AEO, or Answer Engine Optimization, is the work of making sure AI tools mention your practice accurately when someone asks them a question.

An "answer engine" is any tool that replies with a written answer instead of a list of websites. ChatGPT, Gemini and Perplexity work this way, and so do Google AI Overviews (the summary that appears above many Google results) and Google AI Mode.

There are three different ways to appear in one of these answers. Keep them apart:

• Recommended. The answer offers your practice as an option the reader should consider.
• Named in passing. Your practice appears, but is not offered as a choice. It is an aside, a comparison point or the source of a fact.
• Cited as a source. The answer links to your website, or to a page about you, as evidence for what it says, whether or not it recommends you.

Each has different causes and different fixes.

This is what a Google AI Overview looks like for a common patient search:

How AEO Differs from SEO

SEO is about where you rank in a list of links. AEO is about whether you are named in the written answer.

SEO, or Search Engine Optimization, is the long established work of ranking in the lists of links that Google, Bing and other search engines, such as Yahoo and DuckDuckGo, show. In a list, even the seventh result gets seen by someone. A written answer names only a few businesses.

On a results page you can be seventh. In an AI answer, you are named or you are not.

SEO and AEO overlap a great deal, and a clear, well built website helps both. The difference is emphasis. In the AI answers measured by Acuven, AI tools cite reviews, directories and local articles as well as practice websites. You will also hear the term GEO, or Generative Engine Optimization. It has largely the same goal as AEO; Part 2 explains where people draw a line between the two.

Why AI Answers Matter to a Local Practice

When a patient asks an AI tool for a provider, three things decide what that patient sees of your practice.

• Showing up in the answer at all. A written answer names only a few businesses. If yours is not one of them, the patient may never learn that you exist, and a competitor gets the conversation.
• Being recommended. Being offered as a choice is what turns a mention into a reason to call. A practice named only in passing is seen, but it is not put forward.
• Being cited as a source. When the answer uses your page as evidence, patients can follow the link to your own website, and the tool may be treating what your page says as reliable.

Be realistic about size. For local services like med spas, the number of people asking AI tools is modest next to regular Google search, and it is growing quickly. The case for acting now is position, not this month's bookings. Many of the fixes also help your regular search presence, so the work is rarely wasted.

What Decides Who Gets Named

In the AI answers measured by Acuven, the tools draw on reviews, listings, your website and what others say about you.

No AI company publishes a recipe, and each tool behaves differently. Acuven records the kinds of information that feed the answers. For a local practice, five kinds of sources regularly appear in AI answers:

• Reviews. How many you have, how recent they are, and whether they name specific treatments.
• Directory listings. Your Google Business Profile, Yelp and similar sites, and med spa directories such as DiscoverMedSpa, MedSpa Compass, MedSpaNear.me and Medical Spa Directories, with the same name, address and phone number everywhere.
• A website AI tools can read. A site that blocks AI crawlers, or keeps its key text inside images or pop ups, gives the tools less to read.
• Clear service and location information. A page for each treatment you offer, and plain statements of the city and neighborhood you serve.
• Mentions on other sites. Local news, "best of" lists and industry directories that mention your practice give the tools a reference they can cite.

What an AEO Audit Measures

An audit shows, for each tool, whether you were recommended, named in passing or cited, and who was recommended instead.

An audit asks the AI tools the questions your patients ask, live, and records each answer exactly as written, with the date and the locations where the questions were asked. It then reports each tool on its own, because being named by one tool and ignored by another is itself a finding. Blending them into one score would hide it.

A useful audit goes one step further and explains why. It compares the websites, listings and reviews of the competitors who were named with yours, and turns the differences into a list of fixes in plain language.

What to look for in any AEO check. Many free AI visibility checks are a starting point, not an answer. Before acting on one, ask four questions.

• Did it ask the real AI tools, with live search enabled, or estimate from other data?
• Does it show the actual answers, exactly as written?
• Does it report each AI tool separately?
• Does it say when and where the questions were asked?

An Acuven report does all four.

The Acuven report does this across ChatGPT, Gemini, Perplexity, Google AI Overviews and Google AI Mode, for your own locations and services. Part 4 of this series, What an AEO Audit Checks: A Checklist for Med Spas, goes through it in more detail.