Bait and switch in healthcare ads: offers you must actually provide

A new patient special, a whitening offer, a package price for a series of treatments, an ad that names a specific branded product. Each one brings in calls. Each one is also a promise that the practice will provide what the ad describes, on the terms the ad states, to the people who ask for it. When the offer exists mainly to get people through the door so they can be sold something else, the FTC calls it bait advertising, and its guides on the subject are short and specific.

This guide walks through those guides section by section, shows where a practice can drift into them without meaning to, and gives a checklist for running offers that are real. It is written for independent practices, dental offices, med spas, chiropractic and integrative clinics. For how to state a price, see our guide to advertising cash prices. For offers built on the word free, see free consultation offers.

The short version

• Bait advertising is an insincere offer. Under 16 CFR 238.0 it is an alluring offer to sell a product or service the advertiser does not intend or want to sell, used to switch people to something else, usually at a higher price.
• Services are covered, and so is any ad. The definition names services, and “advertising” in part 238 includes any form of public notice, so a website banner, a social post and a search ad all count.
• Telling the truth later does not cure it. If the first contact was secured by deception, the law is violated even when the true facts come out before the patient buys, 238.2(b).
• The FTC looks at what happens after the call. Refusing to provide the offer on its terms, running it down, not having capacity for expected demand without saying so, and pay plans that discourage staff from selling it are all listed signs, 238.3.
• Deposits are a pressure point. Taking a deposit for the advertised item and switching the buyer to a higher-priced one, or not delivering or refunding within a reasonable time, are signs of a switch after sale, 238.4.
• Google Ads has its own rule. Its Misrepresentation policy does not allow ads that promise products, services or promotional offers that are unavailable or not easily found from the landing page.

What the FTC means by bait advertising

Section 5 of the FTC Act, 15 U.S.C. 45(a)(1), declares unfair or deceptive acts or practices in or affecting commerce unlawful. The Guides Against Bait Advertising, 16 CFR part 238, were issued under that section and describe one kind of deception in detail. Section 238.0 defines bait advertising as “an alluring but insincere offer to sell a product or service which the advertiser in truth does not intend or want to sell.” Its purpose, the same section says, is to switch consumers from the advertised item to something else, usually at a higher price or on a basis more advantageous to the advertiser, and its primary aim is to obtain leads.

That last point is why the guides matter for practice marketing. Many practice offers are lead generation by design: a low-priced first visit or a featured service is meant to start a relationship. That is not a problem in itself. The guides draw the line at sincerity. Section 238.1 says no ad containing an offer to sell should be published when the offer is not a bona fide effort to sell the advertised product. If the practice is ready and willing to provide the advertised service, on the stated terms, to the people who ask for it, the offer is real. If the offer is a door that leads only to a different, more expensive service, it is bait.

The ad itself: no false first impression

Section 238.2(a) says an ad should not use any statement or illustration that creates a false impression of the grade, quality, make, value, currency of model, size, color, usability or origin of the product offered, or that otherwise misrepresents it so that the buyer can later be switched once the true facts come out. For a practice, the closest parallels are:

• An ad that names a specific branded product, device or technology when patients who respond are routinely given a different one.
• A photo or description that suggests a more complete service than the price covers, such as a package image showing several treatment areas when the offer covers one.
• An offer that appears open to everyone when, in practice, eligibility rules exclude most callers, and the rules are not stated with the offer.

Section 238.2(b) closes the obvious escape: even if the true facts are later made known to the buyer, the law is violated if the first contact or interview was secured by deception. Explaining the real terms on the phone, at check-in or in the chair does not fix an ad that misled people into calling. The fix belongs in the ad.

After the call: signs the FTC looks at

Section 238.3 says no act or practice should be used to discourage the purchase of the advertised item as part of a bait scheme, and lists the facts it considers when deciding whether an offer was bona fide. Here they are, with the practice situation each one most resembles.

1. Refusing to show, demonstrate or sell the offer on its terms, 238.3(a). A caller asks for the advertised special and is told it is not offered today, not offered to them, or only available bundled with something else that the ad did not mention.
2. Disparaging the advertised item, 238.3(b). Scripts or habits that run down the advertised service, its guarantee, its financing terms or the availability of follow-up care, so that the patient switches. A clinician’s honest recommendation after an examination is a different thing, which we come back to below.
3. Not having enough to meet expected demand, 238.3(c). Advertising an offer widely when the schedule has room for only a handful of appointments, unless the ad clearly and adequately discloses that supply is limited or that the offer is available only at named locations. For a multi-location practice, an offer that runs at one office should say which one.
4. Refusing to take orders for delivery within a reasonable time, 238.3(d). The advertised service exists, but the next opening is so far out that callers are steered to a different service that is available now.
5. Showing a defective or impractical item, 238.3(e). Presenting the advertised option in a way that makes it look unusable for the purpose the ad implied, so that the patient picks the upgrade.
6. Pay plans that discourage selling the advertised item, 238.3(f). Commission or bonus plans for front desk staff or treatment coordinators that pay nothing for the advertised offer, or penalize staff when patients take it. Review how staff are paid before you run an offer.

A note after 238.4 adds that sales of the advertised item do not rule out a bait scheme: some sales may be an incidental byproduct meant to give the operation an air of legitimacy. A practice cannot rely on the fact that a few patients did receive the special.

Switch after sale, and deposits

Section 238.4 covers “unselling”: taking the sale of the advertised item and then working to sell something else in its place. The listed signs are accepting a deposit for the advertised product and then switching the purchaser to a higher-priced product, failing to deliver the advertised product within a reasonable time or to make a refund, disparaging it after the sale, and delivering something defective, unusable or impractical for the purpose the ad implied.

Deposits for procedures, packages and consultations are common in cash-pay care. If a deposit is taken for the advertised offer, the practice should be able to provide that offer within a reasonable time, and should refund promptly under a written policy when it cannot. Our guide to procedure booking deposits and cancellation fees covers the written terms and card dispute side.

Clinical judgment is not a switch, if it is genuine

Part 238 is about insincere offers. It does not address clinical judgment, and a clinician who examines a patient and recommends a different treatment for a documented clinical reason is doing what clinicians are supposed to do. The risk comes when the recommendation is the plan from the start: when the offer is advertised because it brings people in, and the expectation, script or pay plan is that they will be moved to something else whatever the examination shows.

Two habits help keep the line clear. First, offer the advertised service on its stated terms before discussing alternatives, and provide it when the patient still wants it and it is clinically appropriate. Second, record the clinical reason when a different service is recommended, as part of the normal record of care. If a regulator or a patient later asks why so few people received the advertised offer, the answer should be in the charts, not in a sales script.

Search and social ads: Google’s rule

Google Ads applies its own Misrepresentation policy on top of the law. Under the Unavailable offers part of that policy, promising products, services or promotional offers in the ad that are unavailable or are not easily found from the destination is not allowed. The same policy also does not allow offering products or services you do not have or cannot deliver, including not having the right licenses or qualifications, and its Dishonest pricing practices part requires clear disclosure of the payment model or full expense the user will bear.

In practice that means the landing page for an offer ad should show the offer the ad named, with its price and conditions, near the top, and the ad should come down when the offer ends. Our guides to healthcare landing pages and Google Ads for practices cover the rest of the setup.

Making an offer real

A sincere offer is mostly operations. Before you advertise one, work through these points with the people who will answer the phone and see the patients.

• Decide how many appointments the offer can support in the period it runs, and either keep that capacity open or state the limit next to the offer: a number of appointments, an end date, or the locations where it applies.
• Write every eligibility condition into the ad and the landing page next to the offer: new patients only, specific services excluded, age limits, insurance status. If most callers would not qualify, rethink the offer.
• If the ad names a product, device or provider, make sure that is what patients who book the offer receive, or change the ad.
• Give staff a phone script that books the advertised offer first, on its terms, and does not discourage it.
• Check staff and coordinator pay plans for anything that rewards steering patients away from the offer.
• Put deposit and refund terms in writing before the offer runs, and refund on those terms when the practice cannot deliver.
• Turn off ads, posts and website banners on the end date, including Google Business Profile posts and listings on deal or booking sites.
• Keep a dated copy of each version of the ad and a count of how many patients asked for and received the offer; see our guide to advertising records retention.

Questions to ask before an offer runs

• Can we provide this offer, as written, to everyone who is likely to ask for it during the period it runs?
• Is every condition that would stop a caller from getting it stated next to the offer?
• Does the ad, image or product name suggest more than the offer includes?
• What will the front desk say when someone calls for it? Have we written that down?
• Does anyone’s pay depend on moving patients from this offer to something else?
• If we take a deposit, when do we deliver, and when do we refund?
• Who turns the ads off on the end date?

Use and avoid

• Use: “New patient exam and X-rays for [price], new patients without dental insurance, at our Main Street office, through March 31.” Avoid: the same price with no conditions when most callers are told they do not qualify.
• Use: “Limited to 20 appointments this month” when that is the real capacity. Avoid: running the offer across every channel when only a few slots exist.
• Use: the brand name of the product patients actually receive. Avoid: naming one product in the ad and routinely using another.
• Use: a script that books the advertised service first. Avoid: a script that opens with why the advertised service “usually is not enough”.
• Use: a written refund policy for offer deposits. Avoid: holding a deposit for an advertised offer until the patient agrees to an upgrade.

An illustration

This is a made-up example, not a client. A med spa runs a social ad for a single-area treatment at an introductory price. Calls come in, and the front desk script explains that “most people need a full package” and quotes the package price first. The single-area option is booked only when callers insist, and treatment coordinators earn a commission on packages but nothing on the introductory treatment.

Each piece maps onto part 238: disparaging the advertised item (238.3(b)), a pay plan that discourages selling it (238.3(f)), and an ad that secured the first contact on terms the practice did not really mean to offer (238.1, 238.2(b)). The fix is not to stop running offers. It is to rewrite the script so the advertised treatment is booked on its terms, pay coordinators in a way that does not penalize it, state any real conditions in the ad, and record the clinical reason when a clinician recommends more after an assessment.

How we help

We write offer ads, landing pages and lead generation campaigns for independent practices, and we build each offer around what the practice can actually provide, with the conditions stated next to the price. We also build websites, local search and an AI front desk that can answer offer questions with the same terms as the ad. We are not a healthcare provider and we do not give legal or medical advice. Related guides: daily deal sites, fake urgency and countdown timers, holiday and limited-time procedure sales, all-in pricing laws and our guide to healthcare marketing rules.

Sources

• 16 CFR Part 238: Guides Against Bait Advertising (sections 238.0 to 238.4)
• 15 U.S.C. 45: Unfair methods of competition unlawful; prevention by Commission
• Google Ads: Misrepresentation policy (Unavailable offers, Unacceptable business practices, Dishonest pricing practices)

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