Why Review Gating Is a Growing Risk in Healthcare
Online reviews play an increasingly important role in how patients, families, and referral partners evaluate healthcare providers. As competition increases and digital visibility becomes more important, many organizations look for ways to improve their online ratings.
At the same time, regulators and review platforms have tightened their expectations around how reviews are generated. One practice drawing particular scrutiny is review gating.
Review gating occurs when only satisfied patients or families are encouraged to leave public reviews, while negative feedback is filtered out or redirected away from public platforms. Even when unintentional, this practice can create misleading review profiles and expose providers to regulatory and reputational risk.
What Is Review Gating in Healthcare?
Review gating refers to selectively soliciting or publishing reviews based on the perceived sentiment of the reviewer.
Common examples include:
- Asking patients how their experience was before deciding whether to send them a review link
- Only providing review requests to patients or families expected to leave positive feedback
- Redirecting dissatisfied respondents to private forms while satisfied respondents are sent to Google or other public platforms
- Encouraging staff to “balance out” negative reviews with positive ones
In healthcare, review gating is often framed as a quality-control or customer-service effort. However, regulators and platforms increasingly view it as a form of review manipulation.
Although the FTC’s rule is framed around fake or false reviews and testimonials, its underlying principles discourage any practice that distorts the representativeness of review profiles — including selective solicitation or review gating that leads to misleading public perception. The FTC’s guidance on consumer reviews confirms that deceptive or unfair presentation of review data harms consumers and competitors alike. See FTC’s final rule banning fake reviews and testimonials.
Why Review Gating Is Problematic in Healthcare Settings
Healthcare reviews carry unique weight. Families often rely on them during emotionally charged decisions involving care quality, safety, and trust.
Because of this impact, review gating can raise concerns beyond simple marketing ethics:
- Misleading public perception: Selective reviews may not reflect the full range of patient experiences
- Regulatory exposure: Review gating can violate consumer protection and advertising standards
- Platform enforcement: Google and other platforms explicitly prohibit selective review solicitation
- Organizational risk: Patterns suggesting manipulation can trigger complaints from competitors, employees, or families
Healthcare organizations are increasingly expected to demonstrate fair, unbiased review practices.
FTC and Platform Rules on Review Gating
In 2024, the Federal Trade Commission finalized new rules addressing fake and manipulated reviews. While the rules cover a range of deceptive practices, review gating is specifically identified as a prohibited activity.
At the same time:
- Google prohibits selective review requests and review suppression
- Other platforms apply similar standards through their terms of service
Violations can result in:
- Removal of reviews
- Profile suspensions
- Regulatory investigations
- Financial penalties in some cases
Importantly, enforcement does not require intent. Patterns alone can raise red flags.
Common Review Gating Risks in Healthcare Organizations
Healthcare providers often encounter review gating risks unintentionally through operational workflows such as:
- Discharge-based review requests handled inconsistently by staff
- Manual outreach efforts focused on “happy” families
- Informal internal guidance to avoid requesting reviews after complaints
- Staff-written or insider reviews intended to offset negatives
These approaches may feel practical in the moment but can create long-term exposure when review activity appears clustered, selective, or unbalanced.
How Healthcare Providers Can Avoid Review Gating
Avoiding review gating requires a shift from selective outreach to consistent, system-level processes.
Best practices include:
- Offering all patients or families the same opportunity to provide feedback
- Separating internal feedback collection from public review requests
- Avoiding any screening that determines who receives review invitations
- Documenting outreach practices to demonstrate consistency
- Reducing reliance on individual staff judgment
A structured approach helps ensure that review activity reflects genuine patient experiences rather than selective sampling.
Why Consistency Matters More Than Ratings
Healthcare organizations often focus on improving star ratings. However, regulators and platforms are more concerned with how reviews are generated, not just the outcome.
Profiles that show:
- steady, natural review activity
- a mix of feedback over time
- transparent responses to concerns
are generally viewed as more credible and lower risk than profiles that show sudden spikes, one-sided sentiment, or repetitive patterns.
Consistency protects both public trust and organizational credibility.
Key Takeaways for Healthcare Providers
- Review gating involves selectively soliciting or publishing reviews
- Even unintentional gating can create compliance and reputational risk
- Regulators and platforms increasingly scrutinize review practices
- Consistent, unbiased feedback processes reduce exposure
- Long-term trust matters more than short-term rating gains
Healthcare providers benefit most from review strategies built for durability rather than quick fixes.