Online reviews play an increasingly influential role in how patients and families evaluate healthcare providers. Because of this influence, regulators pay close attention to how reviews are collected and presented. One practice that frequently raises compliance concerns is review gating.
Review gating refers to the selective solicitation or filtering of reviews in a way that presents a biased or misleading picture of patient experience. In healthcare, review gating often occurs unintentionally through informal processes or staff-driven outreach.
Understanding what review gating is, why it creates compliance risk, and how it applies to healthcare providers is essential for maintaining transparency and trust.
What Review Gating Means
Review gating occurs when an organization encourages or allows only certain individuals to leave public reviews, typically based on perceived satisfaction. This can involve asking satisfied patients or families to post reviews while discouraging or excluding those who may have had negative experiences.
The result is a public review profile that does not accurately reflect the full range of experiences. Even when the intent is to highlight positive outcomes, selective solicitation can mislead consumers and regulators.
Review gating does not require explicit instructions to suppress negative feedback. Patterns such as conditional outreach, selective timing, or informal screening can still be interpreted as gating.
Why Review Gating Is a Compliance Risk
The Federal Trade Commission regulates deceptive or misleading practices related to consumer reviews. Review gating can raise compliance concerns because it distorts how reviews appear to the public.
When a provider’s review profile reflects only positive experiences, it may suggest a level of consistency or satisfaction that is not representative. Regulators evaluate not only individual reviews, but also broader patterns of behavior.
In healthcare, where trust and vulnerability are central, misleading review practices may receive heightened scrutiny.
Common Examples of Review Gating in Healthcare
Review gating can take many forms in healthcare settings. Common examples include:
- Asking patients or families to leave a review only after positive interactions
- Providing review links selectively during discharge
- Screening feedback privately before deciding whether to request a public review
- Encouraging staff to share review requests only with satisfied families
- Delaying or avoiding outreach after complaints or negative feedback
These practices may feel operationally convenient, but over time they can create patterns that appear selective or deceptive.
Review Gating and the FTC’s Fake and Manipulated Reviews Rule
The FTC’s Fake and Manipulated Reviews Rule addresses practices that create misleading impressions about consumer feedback. While the rule does not use the term “review gating” explicitly in every context, the principles underlying the rule focus on fairness, transparency, and accuracy.
Selective solicitation that results in a distorted review profile may fall within the scope of prohibited conduct when it misrepresents overall experience. The rule emphasizes that reviews should not be filtered or manipulated in ways that deceive consumers.
Healthcare providers should be particularly cautious when review requests are tied to satisfaction scores, staff discretion, or conditional processes.
Why Review Gating Happens in Healthcare
In many cases, review gating is not the result of deliberate misconduct. Instead, it often arises from:
- Staff attempting to protect the organization’s reputation
- Concerns about negative reviews affecting admissions
- Lack of clear guidance on compliant review practices
- Decentralized outreach across departments or locations
- Manual, inconsistent processes
These factors can lead to well-intentioned but risky behaviors that accumulate over time.
How Review Gating Is Viewed by Regulators
Regulators typically assess review practices by looking for patterns rather than isolated incidents. Even without written policies, repeated selective outreach can raise concerns.
Factors that may draw scrutiny include:
- Sudden increases in positive reviews
- Lack of recent negative feedback despite known issues
- Reviewer overlap with staff or insiders
- Timing patterns that suggest filtering
Understanding how review activity appears externally is an important part of compliance awareness.
Reducing Review Gating Risk
Reducing review gating risk begins with consistency and transparency. Outreach practices that provide all patients or families an equal opportunity to share feedback help create more balanced and accurate review profiles.
Clear guidance for staff, documentation of outreach processes, and separation between private feedback collection and public review requests can further reduce risk. The goal is not to eliminate reviews, but to ensure they reflect genuine experiences without selective filtering.
How Review Gating Relates to FTC Review Compliance
Review gating is closely tied to broader FTC review compliance considerations. Practices that appear selective or outcome-driven can create exposure under consumer protection standards.
Healthcare providers navigating review compliance should evaluate not only individual reviews, but also how reviews are solicited and presented over time. Aligning review practices with principles of fairness and disclosure supports both compliance and credibility.
For a broader overview of regulatory expectations, see our guide to FTC review compliance for healthcare providers.
Frequently Asked Questions
Is review gating illegal?
Review gating may violate FTC standards when it results in a misleading representation of consumer experience. Selective solicitation that distorts public perception can create compliance risk.
Does review gating apply to healthcare providers?
Yes. Review gating concerns apply to healthcare providers, including hospitals, skilled nursing facilities, and other care organizations.
Can providers ask only satisfied patients for reviews?
Requesting reviews only from satisfied patients or families can create biased review profiles and raise regulatory concerns.
How can review gating be detected?
Patterns such as clustered positive reviews, lack of balanced feedback, and selective timing of review requests may indicate gating.
For a broader overview of regulatory expectations, see our guide to FTC review compliance in healthcare.