The review rule that changed in 2024, and what it means for a practice.

For a practice that depends on people nearby choosing it, reviews are the strongest asset there is. They outrank the website, they survive algorithm changes, and they are the last thing a patient checks before booking. They are also now the most regulated part of local marketing, and the change is recent enough that most practices are still working from the old assumptions.

The Federal Trade Commission finalised its rule on consumer reviews and testimonials in August 2024, and it took effect on 21 October 2024. Rules of this kind existed as guidance before. The difference is enforcement: the Commission can now seek civil penalties for knowing violations, set at 51,744 dollars per violation when the rule took effect and adjusted for inflation each year. A practice that treats it as a formality is misjudging the size of it.

Start with the prohibitions that are least controversial. Buying or selling fake reviews is out, including reviews generated by an AI tool for something nobody experienced. Nobody defends this one, and it is not where practices get into trouble.

The next one is where they do. Reviews written by insiders have to disclose the connection. That means owners, managers and staff, and it extends to reviews solicited from immediate family without disclosure. In a small practice this is almost never malicious. A new clinic opens with four reviews, and all four are from people who work there or married someone who does. It reads as encouragement from inside the building. Under the rule it reads as an undisclosed insider review.

Then incentives, and here the distinction is fine enough to be worth stating slowly. You may ask patients for reviews. You may not offer anything of value conditioned on the review being positive, whether you say so directly or imply it. A sign offering a discount for a five star review is the obvious version. Front desk staff saying the raffle entry is for happy patients is the same thing said out loud.

The safe construction is uniformity. Ask everyone, ask the same way, and never let what you offer depend on what they are going to say. If an incentive exists at all, it has to be available regardless of sentiment, and that is a hard thing to keep true in practice. Most practices are better off with no incentive and a better ask.

The fourth prohibition is the one that surprises people, because it targets something that feels like ordinary web design. Suppressing negative reviews is out. That includes using unfounded legal threats or intimidation to get one removed, and it includes something quieter: presenting the reviews on your own site as though they were all of them when you have filtered out the unflattering ones.

That last one deserves a moment, because nearly every practice website does a version of it. A testimonials page holding nine glowing quotes, chosen from a pool that also contained complaints, presented with no indication that it was curated. The quotes are real. The impression is not.

Since a list of prohibitions on its own only produces fear, it is worth being equally specific about what remains entirely fine, because it is most of what actually works.

You can ask every patient for a review, routinely, as part of discharge. You can make it easy with a link or a code. You can reply publicly to a negative review, and doing it well is one of the better trust signals available to a practice. You can quote a real testimonial with permission, as long as you do not edit out the qualifier that made it honest. You can feature a review from an employee if you say plainly that they work there.

Put the permitted list beside the prohibited one and the rule turns out to be pointing at a single strategy. The only durable approach is a high volume of genuine reviews, gathered the same way from everybody, without curating what arrives.

That sounds obvious until you notice it is not a marketing problem at all. It is an operations problem. The practices that have hundreds of reviews are not the ones with better campaigns. They are the ones where somebody asks at the same moment in every visit, the request is scripted, and the follow up happens without anyone remembering to do it.

Which is where most practices actually fail. Not from the rule, and not from a lack of goodwill from patients. From asking enthusiastically for three weeks after somebody suggests it, and then stopping, because nothing in the day makes it happen on its own.

The honest version of the advice, against my own interest: this one is free. It costs a sentence in your discharge routine, a printed card, and someone deciding it is not optional. If your review count is low, that is the fix, and it does not require an agency.

What does require help is everything downstream of it, once reviews start arriving and somebody has to answer the ones that are not flattering, keep the responses consistent, and route the enquiries they produce.

A necessary note. This piece describes the FTC rule on the use of consumer reviews and testimonials as published, in effect since 21 October 2024, and reflects guidance available in August 2026. It is not legal advice. Penalty amounts adjust annually, state consumer protection law adds another layer, and a professional board may impose stricter advertising standards on a licensed practice than the federal rule does.