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By Emma Vardy
Business correspondent, BBC News
Medical clinics are using fake Google reviews to boost their profiles online, a BBC investigation has found.
Consumer groups say fake reviews are a "significant and persistent problem" and have called on internet firms to do more to remove them and fine companies.
Which? has warned it could be a serious issue if someone chooses a treatment clinic based on reading a fake review.
The government said it was toughening the law to protect consumers, while Google said it removed fake reviews.
One of the companies the BBC's investigation examined was the Ipswich Spine Clinic run by Dr Amit Patel.
The clinic had a 4.9 star rating on Google reviews.
But our investigation found a number of people who had given this clinic five stars on Google, had also reviewed 16 of the same business in the US, Australia, Austria and Canada, for products as diverse as property conveyancing, car repairs, and hookah pipes.
One of the fake customers wrote: "Dr Amit was brilliant…he assessed my injury quickly and came up with a treatment plan, I felt that I was in safe hands and highly recommend this place".
We also found that five people who had rated Ipswich Spine Clinic highly, posted negative comments on one of their local competitors.
Getting answers
When we contacted the clinic, Dr Amit Patel told us he had outsourced his marketing to a company in India, and hadn't been aware of the reviews posted on Google.
He said since being contacted by the BBC he had asked for reviews which were not genuine to be taken down.
Our investigation also looked at Smiles Better dentistry business in Manchester.
One reviewer Rose Bellamy wrote "I'm so happy with my new smile. Super fast service and everyone was so helpful and kind".
But in the same month, Rose Bellamy had also appeared to review a removal company in Australia, a restaurant in Sweden, an immigration company in Canada, and a spa in the US.
A number of its reviewers who had posted five star ratings on Google had also reviewed the same pattern of businesses around the world.
Smiles Better had replied to some of its fake Google reviews, writing thank you messages.
The dental firm did not provide a response when it was contacted several times the BBC.
'Serious repercussions'
Harry Kind from Which? said "I think it's bad enough if you buy a pair of dodgy Bluetooth headphones off a fake review, but if you try and get a medical treatment done and it turns out that the review you chose the establishment on was fake, that could have really serious repercussions.
Selling them, buying them, and hosting them on your platforms should be illegal, they should be facing a fine there needs to be some deterrent from just buying a load of fake reviews because for now it's easy to do."
A Department of Business and Trade spokesperson said that the government's digital markets, completion and consumers bill will provide new powers to address this.
"We're strengthening the law against fake reviews to protect consumers who spend an estimated £23 billion a year on items based off online reviews.
"We will publish a consultation later this year on our proposals so we are ready to implement these after the Bill receives Royal Assent, including giving the [Competition and Markets Authority] the power to fine these rogue traders."
Google said it does remove fake reviews and suspend fake accounts.
A spokeswoman said: "Our policies clearly state reviews must be based on real experiences, and when we find policy violations, we take swift action ranging from content removal to account suspension and even litigation."