Most businesses can showcase their reviews online as if they were prized gold medals. The healthcare industry, however, is quite different. And not only is it different, but it is also potentially dangerous. Failure to comply with AHPRA and the TGA’s guidelines can result in fines of up to $60,000 per offence for individuals and $120,000 for corporations.

There’s much to discuss regarding reviews and compliance. So in this article, we take a deep dive. I guarantee you’ll learn a lot.

The Basics: What’s the guidance around collecting reviews as a healthcare practitioner

First: a quick refresher.

–       You can ask for reviews, but you cannot ask the patient to refer to their clinical experience/treatment specifically.

–       Reviews & testimonials are strictly prohibited in marketing material you produce, meaning that you cannot display your reviews on your website or on your social media.

That’s the summary. However, it’s a complex topic. Read on.

AHPRA’s testimonial tool for practitioners

Back in 2018, AHPRA published a testimonial tool. It was designed to help advertisers navigate the often-vague rules on reviews and testimonials.

The problem is that it doesn’t go far enough. It’s built around a single flowchart to help determine whether a review counts as a testimonial. But it leaves most questions unanswered.

Practitioners still want to know:

• Can you display your aggregate Google star rating without the written reviews?
• Can you thank a patient for a review without that counting as using it in advertising? What happens with an unsolicited clinical testimonial posted to a page you control but can’t delete?
• Can you run an automatic reviews widget that pulls everything in, since you aren’t curating it?

The tool is silent on all of this, which is exactly where the risk sits for most practices.

A more useful resource would walk through these real-world scenarios rather than stopping at the definition.

So let’s tease this apart a little.

What is the difference between a review and a testimonial?

The guidelines state that not all reviews or positive comments are considered testimonials.

Under the guidelines, reviews of customer service or communication style are not considered testimonials unless they include a reference to the clinical aspects of the patient’s experience.

Clinical aspects include:

• The patient’s symptoms when they sought treatment
• The specific diagnosis or treatment provided by the practitioner
• The outcome of the procedure
• The skills or experience of the medical practitioner, either directly or in comparison with another service

In summary:

• A testimonial includes a clinical aspect of the service.
• A review focuses on nonclinical aspects, such as customer service or communication styles.

You can read more about this under section 4.3.1 “What is a testimonial?” in the AHPRA guidelines for advertising a regulated health service.

Can I display reviews on my website?

I recommend you avoid publishing any reviews or testimonials on your website altogether.

There is a thin grey area where you can display reviews that do not mention the clinical aspects of the patient’s experience. However, the guidelines strictly state that curating or editing reviews can be false or misleading.

Given that you’d be displaying your reviews on a website that you own and have complete control over, it’s extremely difficult not to curate the reviews – and to argue to the regulatory body that you haven’t curated or edited them.

That’s why it may be best to avoid them altogether.

Can I ask for reviews as a medical practitioner?

The guidelines do not specifically state that you cannot ask your patients for a review.

As a best practice, you should frame the question to your patient in a way such as,  “We’d love it if you could leave us a few words about your experience with the clinic and the team”.

This way, you can direct the patient to leave a service comment rather than a testimonial.

Can I curate or selectively edit my reviews?

No. Altering or curating your reviews so that only the best testimonials are displayed is strictly prohibited under AHPRA’s guidelines.

Examples of altering or curating your reviews include:

• Deleting a bad, legitimate review
• Editing a review
• Showing a selection of cherry-picked reviews

Should I respond to reviews on my Google Business Profile?

While the guidelines for advertising a regulated health service, published in 2020, only briefly mention “a regulated health service provider should take care if they choose to engage with reviews on a third-party site as this may be considered using a testimonial to advertise a regulated health service”, the 2023 guidelines for advertising cosmetic surgery directly state in section 4.6 that:

“While medical practitioners are not responsible for testimonials or reviews their patients may post to third-party websites, medical practitioners must take steps to ensure that they do not interact with, or allow testimonials to be published, when they have control of, or over, this function.”

This guideline does not yet apply to all medical practitioners, but I expect that the next review of the advertising guidelines will extend to everyone. So it would be sensible to avoid responding to reviews on your Google Business Profile.

What to do about negative or defamatory reviews

This is a situation that all practitioners and business owners will find themselves in from time to time.

It’s better to wait 24 hours before taking any action and avoid responding in the heat of the moment, especially when the guidelines state that a medical practitioner should not interact with any testimonial posted.

If the testimonial is defamatory, then you should speak to your legal counsel before doing anything.

If the testimonial violates Google’s guidelines, you can flag the review.

What do the TGA guidelines say about testimonials?

The TGA’s guidance on testimonials and endorsements differs from AHPRA’s, which we will unpack in a future article.

Unlike AHPRA, the TGA does allow consumer testimonials in advertising for therapeutic goods, provided that:

• It does not contravene the Therapeutic Goods Act
• It is not inconsistent with the information supplied with the goods
• It does not refer to health benefits that are not typically expected from the goods
• No payment or valuable consideration has been given in exchange for it (anyone who is paid is treated as a marketer of the goods, and their testimonial cannot be used)

Here’s an important caveat for medical practices: Health professionals and anyone else involved in producing, marketing or supplying therapeutic goods are prohibited from giving testimonials or endorsements for those goods.

And when you are advertising a regulated health service, AHPRA’s stricter prohibition on clinical testimonials still applies.

Remember: A practice can meet the TGA requirements and still breach AHPRA, so do not read the TGA position as a green light.

Can I allow reviews on my Facebook page?

Some social media platforms, including Facebook, allow you to disable reviews entirely.

Therefore, on platforms you use in your marketing strategy, it is better to completely disable reviews where possible to avoid the risk of a testimonial being posted.

From AHPRA:

“Not all social media sites allow for editing or removal of testimonials. However, the clinic business owner orpractitioner (whoever has control over the social media) is still responsible for ensuring compliance with the

prohibition on testimonials. This may be achieved by disabling the reviews/testimonials functions.”

So, turn off reviews wherever you can to mitigate the risk of potentially troublesome testimonials.

Can I disable reviews on my Google Business Profile?

Google does not allow business owners to disable, delete or edit reviews.

You can flag a review that breaches Google’s policies, such as spam or one from someone who was never a patient, and ask Google to remove it, but you cannot remove a genuine review yourself.

That sounds like a problem. But it’s what makes Google a safe place for patients to leave a review. GBP is a highly visible third-party platform over which you have no control.

Because you cannot edit what appears, the patient reviews are nothing you are using in your own advertising. So you are not in breach of any compliance guidelines.

In summary, you must not interact with them. Do not reply, share or embed these reviews on your site.

Always seek guidance from your legal counsel and insurer

We’ll always strive to provide you with the most accurate advice, based on the most recent guidelines.

However, the guidelines can be vague and subject to interpretation. Further, we are not lawyers and are not qualified to provide legal advice. Hence, our advice should be taken as general in nature only.

We hope this helps you.

And now, the fine print.

The information in this publication does not constitute legal, financial, medical or other professional advice and should not be relied upon as such. It is intended only to provide a summary and general overview on matters of interest and it is not intended to be comprehensive. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgement and seek appropriate professional advice relevant to their own particular circumstances. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Caffeinated Marketing is not responsible to any person for any loss suffered in connection with the use of this information. Information is only current at the date initially published.

Sources and further reading

–       AHPRA, Advertising hub

–       AHPRA and the National Boards, Guidelines for advertising a regulated health service (December 2020)

–       AHPRA, Testimonials: understand the requirements (testimonial tool)

–       Medical Board of Australia, Guidelines for medical practitioners who advertise cosmetic surgery (from 1 July 2023)

–       TGA, Testimonials and endorsements in advertising

–       TGA, Advertising therapeutic goods on social media