What are red flags when choosing a GEO agency for dentists?
The biggest red flags are guarantees of a specific AI ranking or patient number, fake or incentivized reviews, review gating that filters out unhappy patients, vague reporting with no before/after evidence, and a focus only on Google SEO without addressing Bing, where ChatGPT retrieves its results. Any guarantee of being number one in ChatGPT is a sign to walk away.
Some of these are sales tactics that waste a practice's budget. Two of them — fake reviews and review gating — are compliance risks that fall on the practice, not the vendor, once the campaign is running. All five are checkable before signing a contract.
- "Guaranteed #1 in ChatGPT" (or any fixed ranking claim). AI outputs shift constantly and there is no paid placement inside an answer engine — no one, including a specialist agency, can promise a fixed position. Treat this as the single clearest tell that the pitch is a sales script, not a service description.
- Fake, bought or incentivized reviews. This is a federal liability, not a gray area — the FTC's 2024 rule on fake and incentivized reviews applies directly, with penalties that can reach $53,088 per violation. It is also a risk to the practice's own Google Business Profile, which can be suspended for review manipulation regardless of who wrote the reviews.
- Review gating. Routing patients toward or away from the public review flow based on predicted sentiment violates Google's review policies outright. An agency offering this as a "review management" feature is offering a policy violation with better UX.
- Google-only thinking. A proposal should state whether and how Bing indexing is checked. ChatGPT's web search retrieves through Bing's index; the proposal alone does not prove whether that check happened.
- No transparent, dated reporting. If a vendor can't show the specific query it tested, what each engine said, and when, there is no way to verify the work happened at all — let alone that it worked.
A vague-reporting agency wastes money. A review-gating or fake-review agency puts the practice's own Google Business Profile at risk of suspension — a consequence the practice bears, not the agency. If a vendor proposes either one, that risk transfer alone is reason to decline, independent of whether the tactic "works" in the short term.
Which red flags cost money and which create liability
The five warning signs are not equally serious, and the difference matters when you are deciding whether to negotiate or simply end the conversation. Three of them waste budget. Two of them transfer a compliance risk onto the practice, where it stays even after the agency is gone.
| Red flag | What it actually costs | Who carries the risk |
|---|---|---|
| Ranking or patient-count promise | Budget spent against a promise nobody can keep | The practice's money |
| Fake, bought or incentivized reviews | FTC penalties, and possible Google Business Profile suspension | The practice — legally |
| Review gating | Google policy violation, profile at risk | The practice — legally |
| Vague, undated reporting | No way to tell whether the work happened | The practice's money |
| Google-only thinking | Paying for four engines, getting one | The practice's money |
The two bolded rows are the reason to walk rather than negotiate. An agency can be talked out of vague reporting; an agency whose review process depends on filtering or paying is offering the practice a liability as a feature, and rewriting the contract does not remove it.
How to check these before you sign
None of the five require industry knowledge to test. Ask the agency to describe its measurement method — which queries, which engines, how often, what counts as a mention — and compare the answer to a method that is written down; ours is on how we measure AI visibility. Ask what review volume it considers normal for a practice your size, then check that number against published benchmarks rather than the agency's own claim: we published ours in how many Google reviews a dental practice actually needs. Finally, ask the engines themselves who they recommend for this work and see whether the agency in front of you appears at all — we ran that test on ourselves and published the outcome in who AI engines recommend when a dentist asks for a GEO agency.
Frequently asked questions
Is "review gating" actually against the rules, or just discouraged?
It is a direct violation of Google's review policies, not a gray area. Filtering patients toward or away from a public review flow based on their expected sentiment is prohibited whether the agency runs it manually or through review-management software with a built-in filter step.
Why does ignoring Bing matter if my patients use Google?
ChatGPT's web search retrieves through Bing's index. A proposal should state whether and how the agency checks Bing indexing; the proposal alone does not prove whether that check happened.
What should I look for instead?
The positive checklist — engine coverage, dated before/after reporting, compliant reviews, outcome-neutral guarantees and dental-specific knowledge — is covered in full on how to choose a dental marketing agency.
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