Stock photos, models and actors in healthcare ads: what to disclose

A dental landing page shows a smiling woman in the chair. A video ad has a man in a white coat explaining a new treatment. A social ad cuts between three people who say the clinic changed their life. None of them is a patient or a clinician at the practice. A patient looking at the ad cannot tell that, and the image is doing the talking: it says this is who comes here, this is who treats you, this is what happened to people like you.

This guide covers paid models, actors and stock images of people used in your ads, landing pages and social posts. Real patient stories and before and after photos, and the authorization they need, are in our guide to patient testimonials and before and after photos. Photos of your own team are covered in our guide to staff photos, names and bios, and images made by software in our guide to AI-generated content in healthcare marketing.

The short version

• If an ad presents people as actual patients, the FTC Endorsement Guides say to use actual patients, or clearly and conspicuously disclose that they are not (16 CFR 255.2(c)).
• Using the image or likeness of someone other than the actual endorser is deceptive if it misrepresents a material attribute of the endorser (16 CFR 255.1(g)).
• If an ad implies the speaker is an expert, such as a doctor, the speaker’s qualifications must in fact give them that expertise (16 CFR 255.3(a)).
• Texas lists failing to explicitly identify individuals as models or actors instead of actual patients as false, deceptive or misleading advertising (22 TAC 164.3(b)(4)). California requires a model image to say so in a prominent location in easily readable type (Cal. Bus. and Prof. Code 651(b)(3)(B)).
• Google Ads does not allow misleading statements about your identity, affiliations or qualifications, or manipulated media meant to deceive (Google Ads Misrepresentation policy).
• Stock photos of objects, rooms and scenes carry far less risk than stock photos of people shown as your patients or your clinicians.

What an image says to a patient

Section 5 of the FTC Act makes unfair or deceptive acts or practices in or affecting commerce unlawful (15 USC 45(a)(1)). The FTC Endorsement Guides are the agency’s interpretation of how section 5 applies to endorsements and testimonials (16 CFR 255.0(a)). They define an endorsement as an advertising message that consumers are likely to believe reflects the opinions, beliefs, findings or experiences of a party other than the advertiser, and they list depictions of the name, signature, likeness or other identifying personal characteristics of an individual among the forms an endorsement can take (16 CFR 255.0(b)).

So the question for each person in your ad is the same: what will a patient believe this person is? A face in a banner with no words may be decoration. A face next to the words “I finally sleep through the night” is a patient story. A person in scrubs who says “I recommend this to my patients” is a clinician’s recommendation. The Guides look at the net impression, as their own example of a staged hidden camera ad shows: even when no one is named, viewers may well take the people for actual customers, and if actors were used, that fact should be clearly and conspicuously disclosed (16 CFR 255.2(e)(6)).

Models presented as patients

The Guides state the rule directly. Ads that present endorsements by what are represented, expressly or by implication, to be actual consumers should use actual consumers in both the audio and video, or clearly and conspicuously disclose that the persons in the ads are not actual consumers of the advertised product (16 CFR 255.2(c)). For a practice, the actual consumers are your patients.

• A model in a patient gown under the headline “Our patients” is presented as a patient. Either use a real patient who has signed an authorization, or disclose that the person is a model.
• A video in which actors speak in the first person about their treatment is presented as patient testimony. The disclosure belongs in the video itself, not only in a caption below it.
• Using a stock face next to a real patient’s words is its own problem. The Guides say an endorsement shown with the image or likeness of a person other than the actual endorser is deceptive if it misrepresents a material attribute of the endorser (16 CFR 255.1(g)). Age, sex and visible condition can be material in a health ad.

Disclosure has to work for the people who see the ad. The Guides define clear and conspicuous as difficult to miss and easily understandable by ordinary consumers, and say a disclosure should appear in the visual portion when the claim is visual, in the audible portion when it is spoken, and in both when the claim is made both ways (16 CFR 255.0(f)). In the same section, an ad aimed at older consumers that features actors as app users is judged from the view of older consumers, including those with diminished hearing, sight or cognitive processing (16 CFR 255.0(g)(10)). For a practice whose ads reach older adults, that means text large enough to read and a spoken line in video.

Actors in white coats

An actor dressed as a doctor raises a second issue. Under the Guides, when an ad represents, expressly or by implication, that the endorser is an expert on the subject of the endorsement, the endorser’s qualifications must in fact give the endorser that expertise (16 CFR 255.3(a)). The Guides’ own example is a hearing aid ad whose endorser is called a doctor: the ad likely implies expertise in hearing, and a doctor without that experience might endorse it only with a clear and conspicuous disclosure of the nature and limits of their expertise (16 CFR 255.3(c)(2)).

A white coat, scrubs, a stethoscope and a clinic backdrop all say this person is a clinician. An actor with no clinical training who explains or recommends a treatment in that costume is, in our reading of 255.3(a), presented as an expert they are not. No federal rule we found sets the wording for this case. We recommend one of three things: have your own licensed clinician deliver the message, keep the actor out of clinical clothing and clinical claims, or show and say clearly that the person is an actor and not a clinician.

If the person on screen is presented as one of your doctors, it should be one of your doctors. A stock model on your provider page or in a “meet Dr. [Name]” ad tells a patient something false about who will treat them. Our staff photos guide covers how to show your real team.

Models and results

A model can also stand in for a result: smooth skin after an injectable, a straight smile, a slim waist next to a weight loss program. The Guides say an ad that uses consumer endorsements about a product’s performance is read as a claim that the product works for the purpose shown, and the advertiser needs adequate substantiation for it, including, when appropriate, competent and reliable scientific evidence (16 CFR 255.2(a)). An ad that relates one person’s experience on a key attribute is likely read as showing what patients will generally get, and if you lack support for that, the ad should clearly and conspicuously disclose the generally expected result (16 CFR 255.2(b)).

California is more specific for licensed healing arts practitioners. Its advertising law treats as false, misleading or deceptive a communication likely to create false or unjustified expectations of favorable results, including a photo or other image that does not accurately depict the results of the procedure being advertised or that was altered from the image of the actual subject (Cal. Bus. and Prof. Code 651(b)(3)(A)). A model was not treated at your practice, so a model photo used as a result is not a result. Our before and after photos guide covers how to show real ones.

Texas and California name models and actors

Two large states write the model disclosure into their rules.

• Texas: the Texas Medical Board’s advertising rule lists, in addition to the items in Texas Occupations Code 101.201, failing to explicitly identify individuals as models or actors instead of actual patients as false, deceptive or misleading advertising (22 TAC 164.3(b)(4)). The rule covers advertising regarding the practice of medicine (22 TAC 164.3(a)).
• California: use of a photograph or other image of a model without clearly stating, in a prominent location in easily readable type, that the image is of a model violates section 651(a). For this paragraph, a model is anyone other than an actual patient of the advertising licensee who has undergone the procedure being advertised (Cal. Bus. and Prof. Code 651(b)(3)(B)). Section 651 applies to persons licensed under the healing arts division of that code (Cal. Bus. and Prof. Code 651(a)).

Note the California definition. A real patient of another practice, or your own patient shown for a procedure they did not have, counts as a model there. Other states differ, and boards for dentistry, chiropractic and other professions can have their own rules, so check the board rules for each license in your practice.

Google Ads and images of people

Google’s Misrepresentation policy does not allow misleading statements, or obscuring or omitting material information, about your identity, affiliations or qualifications. It does not allow manipulating media to deceive, defraud or mislead, or claims that entice users with an improbable result as the likely outcome they can expect. Its list of unacceptable business practices includes pretending to provide medical help when you do not (Google Ads Misrepresentation policy).

An actor in a white coat in a search or video ad, a model shown as a patient with a dramatic result, or an edited body image can each run into these policies. Disapproval of an ad is the smaller cost. Google says violations of its unacceptable business practices policy, which includes pretending to provide medical help when you do not, are considered egregious, and that accounts found violating it are suspended upon detection and without prior warning (Google Ads Misrepresentation policy).

Stock licenses: read the terms

We found no federal rule on stock image licenses in health ads. The limits come from the license you agreed to, and from the model release behind it. Before you use a stock image of a person in a health ad, we recommend you read the license and check:

• whether it restricts uses that suggest the model has a health condition, a disease or a treatment;
• whether it restricts uses in medical or health advertising, or uses the license calls sensitive;
• whether it requires a notice next to the image, such as a statement that the person is a model;
• whether the license covers paid ads, not only editorial or website use;
• and whether the image is marked editorial only, which is not for ads.

Keep a copy of the license and the image’s download record with the ad file, so you can show what you were allowed to do when the ad ran.

Where stock images fit

Stock images are not the problem. The problem is a stock person presented as your patient, your clinician or your result. We recommend stock images for what they are good at: rooms, equipment that matches what you use, objects, hands, landscapes for a location page, and abstract images for a topic page. For people, use your own team and, with written authorization, your own patients. Where you do use a model, say so where the patient will see it.

Questions to ask before you run an ad with people in it

• Who is each person in this ad, and what will a patient think they are: a patient, a clinician, a result, or decoration?
• If they are presented as a patient, are they our patient, with a signed authorization? If not, where is the model or actor disclosure?
• If they look like a clinician, are they our licensed clinician? If not, what are they saying, and does the ad disclose that they are an actor?
• Does any image stand for a result? Was that result achieved at our practice on that person, without alteration?
• Is the disclosure in the image or video itself, readable on a phone, and spoken in the audio when the ad speaks?
• Which state boards license us, and what do their rules say about models and actors?
• What does the stock license allow for health ads and paid placements?

Use and avoid

• Use: your own clinicians, named and with their real credentials, when a clinician speaks.
• Use: a short, readable line such as “Model. Not an actual patient.” or “Actor portrayal” on the image or in the video frame, plus a spoken line in video.
• Use: stock images of rooms, equipment and objects, and abstract images for topic pages.
• Use: real patients only with written authorization, as our testimonials guide explains.
• Avoid: actors in white coats or scrubs explaining or recommending treatment without a clear disclosure.
• Avoid: stock faces on your provider page or next to a real patient’s words.
• Avoid: model photos used as before and after images or as results.
• Avoid: disclosures only in a footnote, a page footer or a caption below a video.

An illustration

This example is invented. [Practice name] is an independent med spa in Texas. Its agency drafts a video ad for a skin tightening treatment: an actor in a white coat explains how the device works, then two models say, “I look ten years younger.” A third shot shows a smooth jawline from a stock library.

The owner asks the questions above. The actor is presented as a clinician, so the practice replaces the actor with its own nurse practitioner, who speaks to camera with their name and title on screen. The two models are presented as patients, which Texas says must be identified as models or actors (22 TAC 164.3(b)(4)), and the claim of ten years younger is a result the practice has no support for as a general outcome (16 CFR 255.2(b)). The practice cuts the lines. The stock jawline is a result that did not happen at the practice, so it goes too. The final ad uses the nurse practitioner, footage of the treatment room and a caption with the price of a consultation. No one in it is presented as anything they are not.

Checklist

• List each person in the ad and what a patient will take them to be.
• Replace stock people presented as your patients, clinicians or results, or disclose them.
• Put model and actor disclosures on the image or in the video frame, in readable type, and in the audio for video.
• Check the disclosure on a phone screen.
• Keep actors out of clinical clothing and clinical claims unless the ad clearly says they are actors.
• Use only real, unaltered results, with patient authorization, for results images.
• Check the rules of each state board that licenses someone in your practice.
• Read and file the stock license and model release for each image of a person.
• Check the ad against the Google Ads Misrepresentation policy before launch.
• Have a health care attorney review new ad formats with people in them.

How we help

We build websites, local and organic search, Google Ads and lead generation and an AI front desk for independent practices. For images of people, that means ads and pages built around your real team and your real rooms, with model and actor disclosures on the image itself when a model is used. Our tools are built with HIPAA in mind. We confirm in writing what a BAA covers before any patient information flows through a tool, and if it is not covered, we do not route patient information through it. We are not a healthcare provider and we do not give legal or medical advice. For the wider rules, see our healthcare marketing rules guide.

Sources

• 15 USC 45: Unfair methods of competition and unfair or deceptive acts or practices
• 16 CFR 255.0: Purpose and definitions (FTC Endorsement Guides)
• 16 CFR 255.1: General considerations
• 16 CFR 255.2: Consumer endorsements
• 16 CFR 255.3: Expert endorsements
• 22 Texas Administrative Code 164.3: Prohibited Acts or Omissions in Advertising
• California Business and Professions Code 651
• Google Ads policy: Misrepresentation

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