How we measure

What we check — and what we do not

We check structural trust facts against official public registers: who the responsible physician is, what certification and licence the registers confirm, whether the facility and the legal entity can be traced, whether the clinic discloses its own identifiers, whether its advertising is honest, whether its language fronts agree, and whether patient documents are published.

We do not assess outcomes, skill or complications. A high score means the clinic is well verified, not that treatment there is right for you. This is not medical advice.

The unit

One record = one clinic in this country: brand + address + responsible physician. The named physician is the load-bearing field — every register check is by name. Procedure segment and city are facets, not units.

Inclusion policy

Four mechanical conditions. The first three decide whether a clinic is listed; the fourth whether it can be scored.

1. Identifiable: a live public surface and a working in-country contact on the check date.
2. Provides the service itself: not an aggregator, booking site, affiliate or tour packager.
3. In scope: the intervention is performed by a physician — plastic or aesthetic surgery, hair transplant, physician-led injectables or device treatments, medical weight loss. Out: salons, barbers, nails/brows/lashes, spas, med-spas without a named physician.
4. Names a responsible physician. Otherwise the record is published as verification unavailable: listed, not scored, no rank. Unknown is not fault — a missing name is a statement about coverage, not an accusation.

Country register map

The map for United States was compiled 2026-08-29, before any clinic research. A class marked as absent makes its axis not applicable; a register that cannot be scripted leaves its axis cells as 'could not verify', without penalty. We never simulate a register.

The nine axes

Every axis is a fact or a quote from a public source, scored 1–5 against a fixed rubric. There are no editorial axes. Each cell carries its sources, its source class (official register / secondary) and its check date.

Fame, review volume, domain age and social-media following are scored nowhere.

The formula

Each axis value 1–5 is mapped to 0–1. The composite is the weighted average over the axes that hold a value: axes that are not applicable in this country and axes we could not verify drop out of the normalisation.

composite = 100 × Σ(weight × (value − 1) / 4) / Σ(weight of axes with a value)
score = min(composite + focus adjustment, lowest active ceiling), clamped to 0…100

Coverage threshold: a score is published only when at least 75% of the applicable axis weight holds a sourced value. Below that the record shows 'verification pending' and carries no rank.

Focus adjustment

A mechanical classification from the clinic's own menu.

Score ceilings

A ceiling is applied only from a verified-false finding — never from 'not found'. Each ceiling is rendered from a fixed template with the exact quote or register entry and its URL; no free text is written about a named clinic.

The sanctions ceiling exists only in countries with a machine-readable official sanctions register. In this country: HHS-OIG List of Excluded Individuals/Entities (LEIE) — federal Medicare/Medicaid exclusion register, both an open interactive search and a full monthly CSV; plus Florida MQA 'Discipline on File' / 'Public Complaint' flags on the same open MQA licence record. Absence of a sanction is never a finding.

Holds

Positive verification by default; the hold ladder handles the cases where public records conflict or the physician cannot be identified.

Crowns and procedure slices

A crown is a boolean gate from register-verified axes — never from a clinic's claim. Within a crown, the order is the composite.

Procedure slices list the clinics whose own menu names the procedure (a sourced boolean), ranked by the composite:

• Rhinoplasty
• Breast surgery
• Liposuction & body contouring
• Hair transplant
• Injectables
• Medical weight loss

Outcome quality

There is no independent measurement of treatment outcomes in this field, and we do not imitate one. The register facts already in the axes are the only quality-adjacent evidence we publish.

How the data is produced (unattended run)

1. No score without a source — in two passes. A collector records the value, the quote and the URL; a separate verifier reloads the URL and looks for the quote by string match. If the quote is not found, the cell degrades to 'could not verify'.
2. All negative wording is templated. Ceilings and holds are rendered from fixed strings plus the cited quote or register entry. Nothing free-form is written against a named clinic.
3. The validator is the build gate. Every axis key must be present (null allowed, absence not), every citation must resolve, ceilings only from verified-false findings with a quote, weights must sum to 100, and superlatives in our own text fail the build.
4. A checklist per record: at least two independent sources, the register map opened and cited, every axis either a sourced value or an explicit 'could not verify'.
5. Right of reply without a human in the loop: messages to the contact form or corrections@ are processed as ordinary data input. A correction with a source is applied and logged; a statement without one is published next to the data and the score does not change.

Freshness

Each record shows the real date of its last check. Register axes (M1, M3, M4) are rechecked within 90 days; the advertising axis (M7) within 180 days. Every change is logged in the changelog and in the record's own history.

Methodology versions