I think they are some of the most honest reviews. The 5* are full of gratitude and the 1* are emotion. The 2* is where the truth leaks out. I might call this the Todman 2* test.
Different clinics. Different cities. Different demographics. Different physios. Different ethos. The same line appears in the 2* over and over: "Felt rushed." "Was meant to be 30 minutes." "Didn't feel like I got the full session."
That's not about a couple of rogue minutes. That's a value complaint. Patients don't know whether your clinical reasoning was sharp. They know whether they felt properly dealt with.
Time only becomes visible when progress doesn't.
I didn't sell 30-minute blocks - and still don't. I was there to solve the problem. Sometimes that meant 15 mins and a very clear plan. Sometimes it meant 40. If someone needed less, I didn't stretch it to justify the fee. I'd just say, "That's your lot." Padding sessions simply devalues judgement. If someone needed more, I didn't hide behind the diary. They got what they needed, with gushing apologies to the next patient, and the story.
Getting better doesn't run like clockwork. Your diary shouldn't either.
The goal was simple: see it, sort it, sell the solution - not the session. Patients don't buy treatment. They buy progress. They buy into the person delivering it.
If your model is built around filling billable time rather than fixing problems, those 2* reviews won't disappear. They'll just keep quietly yelling the truth.