A regional health system invested $50,000 optimizing their cardiology content. Six months later, ChatGPT cited their program in 68% of AI searches for heart care. Their patient volume stayed flat. When we surveyed 200 new patients, only 22% cited AI recommendations as their primary reason for choosing the practice. The other 78% chose based on physician reputation, name recognition, and family referrals. This is the AI Citation Paradox. You can dominate AI search visibility a