Google has significantly tightened enforcement of its review policies, and the changes could impact how your chiropractic practice collects patient feedback. Understanding these new rules is essential for protecting your hard-earned online reputation and Google Business Profile.
If you’ve been asking patients for reviews at checkout, offering incentives for feedback, or using in-office tablets for review collection, it’s time to adjust your approach. Here’s what you need to know to keep your practice safe while continuing to build trust with authentic patient reviews.
What Is Google’s “Fake Engagement” Policy?
Google’s fake engagement policy prohibits any practice that manipulates or artificially inflates review counts. While this policy isn’t entirely new, Google has ramped up enforcement significantly in 2025. The platform now uses sophisticated detection methods, including IP address tracking, location data analysis, and behavioral patterns, to identify and remove suspicious reviews.
What’s at Risk: Practices Google Now Prohibits
Google has drawn clear lines around what constitutes fake engagement. Here are the specific practices that put your Google Business Profile at risk:
Incentivizing Reviews
Offering any form of compensation in exchange for reviews is strictly prohibited. This includes discounts on services or future appointments, free products like supplements or wellness items, gift cards, cash payments, or entry into contests and raffles. The critical point to understand is that this applies even if you’re asking for honest reviews or not requiring positive feedback. Any incentive whatsoever violates Google’s policy.
In-Person Review Requests at Your Office
Google specifically discourages soliciting reviews while patients are physically at your practice. Common violations include QR codes displayed at the checkout counter, tablets or devices in your office for leaving reviews, staff members asking patients to leave reviews before they leave, or any method that creates immediate pressure to review.
When patients leave reviews from your office’s IP address or location, Google may flag them as potentially coerced or inauthentic, even if they’re genuine.
Selective Review Solicitation
Google prohibits practices that manipulate your overall rating. This includes only asking satisfied patients for reviews, discouraging or prohibiting negative reviews, offering incentives to remove or revise negative reviews, or posting fake reviews on competitors’ profiles.
What Google Allows: Safe Review Collection Practices
Don’t worry, you can absolutely still ask for reviews. You just need to follow Google’s guidelines to ensure your approach is compliant and sustainable.
Email and Text Follow-Ups Are Your Best Bet
The safest and most effective way to collect reviews is through automated email or text message follow-ups after appointments. This method gives patients time to reflect on their experience, allows them to leave reviews on their own device and timeline, and shows Google that reviews are voluntary and authentic.
After a patient’s appointment, an automated system sends a follow-up message thanking them for their visit and providing a direct link to your Google Business Profile. The patient can choose whether to leave a review, with no pressure or incentive attached.
Let Patients Use Their Own Devices
Reviews should always be left on the patient’s personal device, whether that’s their phone, tablet, or computer at home. This creates the voluntary, authentic engagement that Google values and prevents red flags like multiple reviews from the same IP address, clusters of reviews left within minutes of each other, or reviews from devices associated with your business location.
Encourage, Don’t Pressure
You can absolutely encourage patients to leave reviews, as long as you’re soliciting genuine experiences without incentives or immediate pressure. Appropriate language includes phrases like “We’d love to hear about your experience! If you have a moment, please share your feedback on Google,” or “Your opinion helps us serve our community better. We welcome your honest review,” or “Many of our patients find us through online reviews. If you’d like to help others discover our practice, we’d appreciate your feedback.”
Why This Matters for Your Chiropractic Practice
These policy changes aren’t designed to make your life harder; they’re intended to protect both businesses and consumers from fake or manipulated reviews. Here’s why compliance matters:
Protect Your Existing Reviews
If Google detects policy violations, they can remove multiple reviews from your profile, including legitimate ones. Imagine losing dozens of authentic five-star reviews because a few were flagged as potentially incentivized.
Avoid Google Business Profile Penalties
Businesses caught violating the fake engagement policy may face temporary suspension of new reviews, reduced visibility in local search results, or, in severe cases, removal of your Google Business Profile entirely. Rebuilding after these penalties can take months and significantly impact your new patient acquisition.
Build Long-Term Credibility
Reviews collected through compliant methods are more valuable because they’re sustainable. Authentic patient feedback stands up to Google’s scrutiny over time, provides genuine insights that help your practice improve, and creates trust with potential patients while strengthening your local SEO without risk.
Action Steps: Update Your Review Strategy Today
If you’ve been using any of the prohibited methods, don’t panic, but do make changes immediately. Here’s how to transition to a compliant review collection strategy:
Remove In-Office Review Prompts. Start by taking down any QR codes at checkout, removing tablets or devices used for review collection, and training your staff to avoid asking for reviews while patients are in the office.
Set Up Automated Follow-Ups. Use email or text automation to reach out after appointments. Include a direct link to your Google Business Profile and keep messaging simple and pressure-free. If you’re a Perfect Patients client, simply add new patients as subscribers to your dashboard; this automatically triggers compliant review request follow-ups.
Audit Your Current Review Collection. Review your existing processes for any policy violations. If you’ve offered incentives in the past, stop immediately. Consider consulting with your digital marketing provider about best practices.
Educate Your Team. Make sure everyone understands the new rules. Provide scripts for how to respond if patients ask about leaving reviews in person, and emphasize the importance of genuine, voluntary feedback.
Pro Tip: If you’re using automated review management software (like many Perfect Patients clients do), verify that it follows Google’s guidelines by sending requests via email or text after patients have left your office.
The Bottom Line
Google’s stricter enforcement of review policies means that the days of in-office review requests and incentivized feedback are over. But this isn’t a setback, it’s an opportunity to build a stronger, more authentic online reputation.
By following compliant practices and collecting reviews through email or text follow-ups, you’ll not only protect your Google Business Profile but also gather more meaningful patient feedback that genuinely helps your practice grow.
The chiropractors who thrive in 2025 and beyond will be those who prioritize authentic patient experiences over shortcuts. Start building that foundation today.
Ready to build a compliant review strategy that protects and grows your practice?
At Perfect Patients, reputation management is part of our service offering. We help chiropractors collect authentic reviews safely while staying on the right side of Google’s policies.
Our automated systems reach patients after their appointments through email or text, giving them time to share genuine feedback on their own terms. Schedule a free consultation to learn how we can strengthen your online reputation without the risk.