In this video, Etna Interactive CEO Ryan Miller discusses an important update affecting Google reviews and online reputation management for elective healthcare practices. If you’ve noticed legitimate reviews disappearing from your Google Business Profile, this change may help explain why.
Follow along to learn what changed in Google’s review policies, why reviews that mention staff members or follow repeated patterns may be at higher risk of being suppressed, and how your practice can adjust review requests to encourage genuine, uncoached patient feedback.
Video Transcription:
Ryan: Hey, again, it’s Ryan Miller with Etna Interactive. And if you’ve noticed legitimate Google reviews disappearing from your Google Business Profile, you’re not imagining it.
It’s a real issue because Google made a major policy change in April, and we’re going to talk about it today and how to avoid falling afoul of their new policies.
So, let’s just highlight a little bit about how Google reviews are working in general today. Google has long had systems in place that automatically check for reviews for signals of veracity.
In 2025 alone, they deleted or suppressed nearly 300 million reviews. Many of them are, in fact, legitimate because the patterns or the signals inside those reviews triggered Google’s tooling, and they just get flagged and, as a result, get suppressed.
Specifically, though, today, reviews that name staff, reviews that are clustered by timing, or follow similar patterns of language are at extreme risk of getting flagged and suppressed.
So, we just need to acknowledge it’s not a glitch. It’s a feature. Google’s working the way it’s supposed to work, and you need to understand how it works so that your reviews stick.
Now, here’s what changed back on April 17th. They updated a formal policy relating to ratings manipulation. They added two new clauses, and they changed the third clause that was soft to make it more explicit.
Specifically, they added a prohibition against asking people—your patients and prospects—from leaving reviews that mention staff members by name.
They also banned quotas. You’re no longer allowed to require staff members to trigger a certain number of reviews inside of a certain time window.
And where previously they had a soft prohibition encouraging practices, not to mention five-star reviews by name, it’s now explicitly written in. It’s a hard prohibition that you can’t ask for: “Please leave us a five-star review on Google.”
So, ultimately, what they’re looking for is reviews that just reflect the patient’s real-world experience, and in their own words.
What’s super interesting about this is actually what happened the day before April 17th. Now, we need to understand that Google’s facing a major, fairly existential challenge, both for their local search ecosystem and for their AI search ecosystem.
It has become, with the rise of and the availability of AI agents, very easy for bad actors, for unscrupulous businesses to hire firms or, on their own, deploy systems that will cheaply, scalably, and increasingly difficult to detect, leave fake reviews for businesses to try to inflate the reputation online.
Now, what we have to recognize is this is a big deal to Google because Google local search results and Google AI systems both rely heavily on the accuracy of this review content.
So, they’ve really deployed a big upgrade. And on April 16th, they made an announcement. They’re applying their own internal Gemini AI system in place of older, sort of static algorithms to read and study the review content, looking for signs and signals that it may be fake, that it may be AI-generated.
Because at the end of the day, quality matters to them, and it’s about them protecting the integrity of their whole reviews ecosystem for very good reason. It’s not about them being arbitrary with you (“We’re trying to punish your practice”).
Here’s the shift that we need to start with and, and it’s a mental one. If you have looked at reviews and said this is, strictly speaking, a numbers game, well, it’s time to shift your thinking. It’s no longer just about the straight number of reviews or the absolute rating that you receive.
Authenticity of review content is more important than ever, especially if you want a patient’s review to stick. Scripts, templates, prompting patients to drop names, those are all going to work against you because those are the things that the AI system is likely to pick up on as suspected AI or false review activity and to flag and remove from your profiles.
In addition to that, we just have to acknowledge like what’s the new success measure? What does success look like? Well, it’s uncoached but specific, genuine patient reviews that are in their own language, that follow natural language patterns and that reviewer’s own review history.
So ultimately, what does it mean? It means it’s just your collection strategy needs to shift and here’s how. First thing you need to do is inventory all the ways you ask patients for reviews. Take the time to figure out, do we have a review request coming out of our CRM system? Do you use something like Etna’s Reputation Ally? Have you printed cards? Do you have emails that staff members send out to patients manually?
Take the inventory of all those things and edit them. We need to pull out those requests to follow a specific structure or mention a staff member by name, or specifically, to leave a five-star review and replace it with much simpler language that just encourages patients to share their experience in their own words for the benefit of other patients.
Now, importantly, if you’re an Etna client, we’re going to be doing this with you whether you like it or not as a part of our July account review. If we don’t bring it up first, feel free to bring it up. Our account managers are excited and eager to talk to you about it as we wrap up here.
This is the biggest thought for the presentation I want you to take away is that, really, the future of online ratings reviews is about this uncoached, specific, genuine patient language. That’s the new signal for online reputation success.
If you have questions about our findings or research. Please feel free to contact us here at Etna Interactive or subscribe to our newsletter to receive more educational content. Again, I’m Ryan Miller. Thanks for your time today.
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