Flags

A flag is a documented, sourced concern about a specific factual claim. Flags are orthogonal to verification tier — a Tier-2 clinic can be flagged, and a flag can be raised or resolved without changing the tier. We never remove a flagged record; we preserve the history.

Flag types

accreditation-unverified: The clinic claims an accreditation that we cannot find on the issuing body’s public register. We open the flag, log the search performed, and offer the clinic a right of reply.
accreditation-expired: The accreditation appears on the issuer’s register but the validity date has passed.
dissolved-and-reregistered: The corporate entity was dissolved and a new entity registered at the same address with similar branding — a documented liability-reset pattern. We log dates, registry filings, and offer the clinic a right of reply.
review-bombing: Statistical anomalies in the clinic’s public review record consistent with paid review activity: clusters of 5-star reviews from accounts with no other review history; identical or near-identical wording across multiple reviews; sudden ratings shifts uncorrelated with operational change. Methodology in src/lib/community.ts.
surgeon-credential-disputed: The clinic publicly attributes a procedure to a named surgeon whose registration we cannot confirm on the relevant council’s register. We open the flag and attempt to contact the clinic for clarification before publishing.
consent-clause-unenforceable: The clinic’s standard consent contract contains a clause we believe is unenforceable in the patient’s likely home jurisdiction (e.g. blanket negligence waiver for UK patients). Reviewed by qualified counsel before flag is raised.

Lifecycle

open — concern documented; clinic informed; right of reply offered.
resolved — the underlying concern has been addressed. The flag remains in the record with the resolution narrative.
withdrawn — the concern was raised in error; we publish the correction.

Right of reply

Every flag offers the clinic a right of reply, which we publish verbatim alongside the flag. We do not redact factually incorrect replies; we leave the reply visible and add an editor’s note explaining what is incorrect.

Worked example (anonymised)

A real flag from our records, with the clinic and surgeon names replaced by placeholders to illustrate the lifecycle in practice.

Step 1 — concern raised

A verifier preparing the entry for “Clinic A” (a dental clinic in a major medical-tourism destination) noted that the clinic’s website displayed a JCI accreditation logo, but the JCI Gold Seal search returned no result for that clinic, its parent company, or any closely-named entity. Flag type: accreditation-unverified. The flag was raised internally and the JCI search URL, search terms, and result page were archived to the Wayback Machine.

Step 2 — clinic notified

The registry contacted the clinic via the email address on its website, summarising the flag and the search performed, and asked for either (a) the JCI certificate number and expiry date for verification with JCI directly, or (b) clarification of which entity held the accreditation. A 30-day reply window was offered.

Step 3 — reply received

The clinic replied within 10 days. It clarified that the JCI logo referred to a partner hospital group’s accreditation, not to the clinic itself, and that the logo placement had been an inherited template error from a website rebuild. The clinic committed to removing the JCI logo within 7 days.

Step 4 — resolution

The registry confirmed the logo removal by re-checking the website after 14 days. The flag was marked resolvedwith the full narrative (search performed, clinic reply, resolution action) preserved in the clinic’s public verification log. The clinic record now reads: “Flag raised 2026-01-15 for unverified JCI claim; resolved 2026-02-04 after clinic confirmed logo placement was an inherited template error and removed the claim.”

What this example illustrates

Flags are documented concerns, not allegations of fraud.
The clinic’s reply is treated as part of the record, not as an attempt to be defeated.
Resolution preserves the history — the flag is not deleted.
The factual question (was the accreditation claim accurate?) is the only thing the flag judges.