What are the red flags before a clinic hires a marketing agency?
Updated 8 min readFacts checked
Guaranteed patient numbers, unranked "best in city" claims, incentivised reviews and before/after ads all sit close to or over NMC and ASCI rules. Check who owns your Google Business Profile, whether ad spend hides inside one invoice, and whether reports show bookings or only impressions. The risk sits with your registration, not the agency's.
Key takeaways
- Guaranteed patient numbers, unranked "best in city" claims, incentivised or filtered reviews, and before/after result ads all sit close to or over NMC regulation 6.1.1, regulation 7.17 and the ASCI Code.
- If an ad or review scheme run in your clinic's name later gets flagged, the professional-conduct exposure lands on your registration, not the agency's business.
- Check who is primary owner of your Google Business Profile and ad accounts before you sign. Reclaiming ownership later takes days, not minutes, and needs the current owner to respond.
- Ask for calls, WhatsApp enquiries and booked visits every month, not impressions or followers, and set up your own monthly export from day one so leaving later is easy.
On this page
A marketing agency that is comfortable with your questions will answer them before you sign, not after. Here is what to check, in the pitch, the contract and the monthly report.
Which promises from a marketing agency are red flags?
An agency does not need to be registered with the NMC to work with your clinic, but the ads and reviews it produces still carry your clinic's name, and indirectly your medical registration. Five promises doctors report hearing in agency pitches sit close to, or over, a real rule.
| What you might be promised | Why it's a red flag |
|---|---|
| A guaranteed number of new patients a month | NMC regulation 6.1.1 makes it unethical for a physician to solicit patients "directly or indirectly" (Indian Kanoon, regulation 6.1 (opens in a new tab)). No agency decides whether an enquiry books and turns up, so a guarantee is a promise kept behind your name, not the agency's. |
| "Best [specialty] in [city]" or a similar ranking claim | The ASCI Code requires a ranking claim to name "the organisation that has provided the award/ranking and the month and year" it was given (ASCI (opens in a new tab)). An unranked "best" line is exactly the pattern that guideline exists to catch. |
| Fast reviews, or reviews only requested from happy patients | Google's policy bans paying for reviews and "selectively soliciting positive reviews" (Google's user-contributed content policy (opens in a new tab)), a practice known as review gating. The review sits on your clinic's own Business Profile, so it is your listing that gets penalised if reviews are removed. |
| Before/after photos or patient testimonials in the ad | NMC regulation 7.17 bars publishing a patient's photo or case report in a journal or other publication in a way that identifies them, without permission (Indian Kanoon, regulation 7.17 (opens in a new tab)), and a result used to promote the clinic can still read as the publicity regulation 6.1 rules out, even with the face hidden. |
| A stated success rate for a treatment | Comparative or outcome claims need evidence you can point to under the ASCI Code (ASCI (opens in a new tab)), and a treatment's success is rarely something one clinic can honestly reduce to a single percentage. |
Not legal advice. If an agency asks you to approve any of the five, ask which rule it checked against first.
How do you read an agency's case study without being fooled?
A specific number feels more convincing than a vague promise, which is exactly why case studies are the centrepiece of most agency pitches. Ask three questions of any number you are shown: compared to what, over what period, and whose clinic. Here is a real, public example to practice on.
| Claim on the page | Named clinic? | Baseline given? | Timeframe given? |
|---|---|---|---|
| "Best Healthcare SEO & PPC Agency in Delhi, India" | No | No | No |
| "We got 37 new patient leads in 28 days," attributed to a named doctor | Yes, an eye clinic in Delhi | No, the page does not say how many leads the clinic got before | Yes, 28 days |
| "240% increase in organic appointment bookings" | No, an unnamed paediatric clinic | No | Not clearly dated |
Quoted here to show how to read any agency's case study, not to say the underlying numbers are false. Agency name withheld.
None of this proves a number is wrong. It shows what you cannot check from the page alone. A percentage with no starting point can describe real growth or one unusually good month, and there is no way to tell which from the ad. A quote naming a real clinic is more checkable than an anonymous one, but it still does not say what happened to those 37 leads afterward, how many became booked appointments, or how many patients actually walked in. Ask any agency for the same three things behind every case study it shows you: the number before, the number after, and how it counted a "lead" or a "booking".
What contract terms should make you pause before signing?
Most disputes with an agency trace back to a clause nobody read closely at signing. Five are worth checking line by line, ideally before you hand over a single login.
Contract terms to check before you sign
How long you are locked in, and what it costs to leave early.
A short initial term with an easy renewal is safer than a long lock-in with a penalty for stopping.
Whose name every account is opened in.
Your Google Business Profile, ad accounts, website domain and social handles should list your clinic as owner, not only the agency.
Whether ad spend and the agency's own fee sit on one combined invoice.
One number makes it hard to see how much Google or Meta actually kept versus what you paid the agency for its work.
What you get back if you cancel.
Ask, in writing, whether creative files, keyword lists and account access transfer to you or stay with the agency.
Whether the contract renews automatically.
Note the notice period you would need to give, and put a reminder on your own calendar, not the agency's.
What should a monthly report from an agency actually show?
A report full of impressions and followers can look busy while telling you nothing about your appointment book. The table below is what many agency dashboards default to, next to what actually tells you the work is paying off.
| What many reports lead with | What it doesn't tell you | Ask for this instead |
|---|---|---|
| Impressions or reach | How many people saw an ad, not whether any of them did anything about it | Number of calls or WhatsApp messages the ad or post led to |
| Followers or likes gained | Social media growth is not the same thing as new patients | Number of enquiries that can be traced back to that platform |
| Clicks, or "leads" | A click can be a wrong number, a curious scroller, or a competitor checking your ad | Booked appointments, and where possible, patients who actually attended |
| Website visits | Traffic with no phone call or WhatsApp click never reaches your front desk | Calls and WhatsApp clicks tracked from the website itself |
General patterns worth checking for, not a description of any one agency's reporting.
If a campaign breaks a rule, who is responsible, you or the agency?
You are. NMC's 2002 regulations sit on a doctor's medical registration, not on a marketing company's business licence, because the NMC has no authority to act against an agency. Regulation 6.1.1 restricts what a "physician" may do to solicit patients, and regulation 7.17 restricts what a physician may publish about a patient (Indian Kanoon, Indian Medical Council regulations, 2002 (opens in a new tab)). Both address the doctor, because the doctor is who the NMC can act against. If a campaign the agency wrote crosses that line, it is your registration a complaint gets filed against, not the agency's.
This is also why it matters whose name your Google Business Profile is under. If the agency set it up and made itself primary owner, Google's own process to move ownership back to you takes at least a few days after you ask: the current owner is notified and has time to respond before you get another way to claim it (Google Business Profile Help, requesting ownership (opens in a new tab)). Only an owner can change who holds primary ownership in the first place (Google Business Profile Help, transferring ownership (opens in a new tab)). Confirm you are listed as primary owner before you sign, not after a dispute has already started.
The same logic applies to any Google Ads account run in your clinic's name; our guide to Google Ads rules for clinics in India covers what Google allows there. And if reviews on your listing ever look manipulated either way, genuine or fake, our guide to fake Google reviews at your clinic covers what Google actually removes and how to report it.
What to ask first, and what to do in the first 30 days
A good agency answers the questions below without hesitation. Ask them in the first meeting, whichever agency you eventually choose.
- Which accounts will be in my clinic's name, and which in yours?
- Can I see a case study with the number before and after, not only the after?
- What exactly is included in the monthly fee, and what is billed separately?
- How do you ask patients for reviews, and can I see the actual message?
- What happens to my accounts and data if I leave in three months?
Whichever agency you sign with, the first month is when you set up the habits that make leaving easy later, if you ever need to.
Step 1: Day 1: collect every login
Google Business Profile, ad accounts, website hosting and domain, and any social handles opened for the clinic. Save them somewhere only you and your staff control.Step 2: Week 1: confirm you're the primary owner
On Google Business Profile specifically, check that you or a staff member holds primary owner access, not only manager access, so nobody else can lock you out.Step 3: Weeks 2 to 4: set up your own monthly export
Ask for review count, profile views and total enquiries (calls plus WhatsApp messages) as plain numbers sent directly to you, not only inside an agency's summary slide.Step 4: End of month 1: compare against the invoice
Line up what the report actually shows against what you were billed, and confirm in writing what you keep if you decide to stop.
None of this needs an agency at all to be worth doing. A clinic running its own Google Business Profile and WhatsApp number can set up the same habits, which is a large part of our full guide to getting more patients within NMC and ASCI rules.
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Common questions
Can a marketing agency legally guarantee a number of new patients?
No agency controls whether an enquiry actually books and turns up, so a guarantee is a promise it cannot keep. NMC regulation 6.1.1 makes it unethical for a physician to solicit patients directly or indirectly, and it is your registration behind that guarantee, not the agency's.
Is it fine for an agency to use before-and-after patient photos in ads?
Be careful. NMC regulation 7.17 bars publishing an identifiable patient's photo or case report in a journal or other publication without their permission, and a result used to promote the clinic can still read as the kind of publicity regulation 6.1 rules out, even when the face is hidden.
Who owns my Google Business Profile if an agency set it up?
Whoever the agency made primary owner, unless you check and change it. If that is the agency, you can request ownership from Google; the current owner then has 3 days to respond before you get another way to claim it.
Can I leave a marketing agency partway through a contract?
That depends on what you signed: the lock-in period, the notice you owe, and what it says about your ad accounts and creative files. Read those clauses before you sign, not when you already want to leave.
Is a case study naming a real doctor and clinic proof the results are genuine?
It is more checkable than an anonymous one, but naming the clinic still does not tell you the number before the campaign, over what period, or how a "lead" was counted. Ask an agency for those three things separately, for any case study it shows you.
Facts checked against the sources listed on this page.
Sources
- 1.Indian Kanoon: Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 (checked 17 Sep 2026)
- 2.ASCI: The ASCI Code and guidelines (checked 17 Sep 2026)
- 3.Google Maps: User-contributed content policy (prohibited and restricted content) (checked 17 Sep 2026)
- 4.Google Business Profile Help: Transfer primary ownership of a Business Profile (checked 17 Sep 2026)
- 5.Google Business Profile Help: Request ownership of a Business Profile (checked 17 Sep 2026)
Update log
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