Assuming (big if) Gunson is aware of this or even involved, I think what makes this all the more disappointing is that he is, at a minimum, an above-average surgeon, with many happy patients, has no shortage of business and makes millions a year. He doesn't need to do this. Of course, he makes thousands off a single surgery, and to the extent a single bad review turns away a single surgery, one can see the enormous incentives to suppress bad reviews or put up positive ones.
I'd agree he is overrated compared to say, a Wolford, who has pioneered multiple surgical techniques, like the step osteotomy, the modified BSSO cut, the use of porous HA for grafts, mentalis resuspension technique, etc., and is revered by other OMFS. Gunson is barely cited in the literature, but probably produces good results frequently. The reviewer in question has, I think, a good result, which makes her disclosing the relationship all the more costless. "Yes, I work for him, but my face speaks for itself, and my Instagram shows that he actually did do a surgery on me and that it was successful."
I suspect Google is in bed with the businesses on its pages. It has watered down its review COI policies over the years, for example, employee reviews used to explicitly be prohibited, now it just says reviews should be "honest and unbiased." We are sorely lacking a citizens watchdog group to police unethical medical advertising. Nobody is really policing this with any degree of effectiveness. The use of other OMFS's patients photos, conflicted reviews, fake reviews, unverified or ambiguous claims about the volume of publications or surgeries, stock photos, claims like "top surgeon", the absence of disclaimers, etc. The unethical practices are rampant. Medical advertising should inform, not manipulate. Frankly, this site is probably what comes closest to a watchdog, though it's also highly imperfect.
