Twelve chapters in, a human has picked every word a patient sees in these podiatry ads. Chapter 4 matched each ad to its page. Chapter 8 wrote headlines from what patients said. Chapter 9 switched off the setting that lets Google write its own.
AI Max is that setting, and it's the last thing a podiatry account turns on. When it's on, Google writes new ad text by reading your website: the landing pages, the condition pages, the blog, everything on the domain. It doesn't know which sentences you'd defend in front of a state board and which ones a web designer wrote in 2019. If a page says "cure," the ads can say it too.
AI Max Reads Everything on the Site When It Writes a Podiatry Ad
AI Max for Search campaigns bundles three features, and all three hand a decision to Google:
- Search term matching shows your ads on searches beyond your keywords, the way broad match does.
- Text customization writes new headlines and descriptions. Google says it draws on your domain, your landing pages, your existing ads and the keywords in the ad group.
- Final URL expansion decides for itself whether a bunion click belongs on the bunion page you set or somewhere else on the domain. A heel pain click could land on a blog post about home stretches instead of the heel pain page Chapter 4 built for it.
Per Google, none of the three performs properly without Smart Bidding that optimizes toward conversions, and conversions are exactly what a young podiatry account doesn't have yet. It needs a campaign that already knows what a booked patient looks like, which means Exploration, the broad match campaign from Chapter 6, running on a target CPA with months of conversions behind it. (Exploration and Isolation are BrandRocket's names for the two Search campaigns, not Google settings.) Isolation, the exact match campaign, never gets AI Max. Its whole job is control.
In the order this guide has followed, AI Max comes after Performance Max, the subject of Chapter 10,, and usually many months into an account. By then the practice has a real cost per booked patient, a negative keyword list built from months of search terms, and a clear sense of which pages convert. Those are the guardrails AI Max works inside.
Google ticks the AI Max box on every new Search campaign it creates, which is why Chapter 9 unticked it on day one. This chapter is about what to do before switching it back on.
Four Podiatry Sites Say "Cure." Nine Say "Permanent" or "Painless."
We read the pages of 12 podiatry practices in our example market, Los Angeles, and noted every claim about results. The claims AI Max could lift were everywhere:
- "Cure" appears in a treatment claim on 4 of the 12 sites: "94% cure rates" for a laser treatment, "The only true cure for these painful conditions is surgery," and a toenail page saying removing the nail "permits the fungal infection to be cured."
- "Permanent," "permanently" or "eliminates" appears in a result claim on 9 of 12.
- "Painless," "pain-free" or "no pain" appears on 9 of 12, including one page titled "Painless Bunion Surgery."
- A success percentage appears on 7 of 12: "success rates exceeding 99%," "99+% Outcome Satisfaction Scores," "72% - 80% success rate."
Only one of the 12 sites said, anywhere we looked, that "results are not guaranteed."
These weren't hidden in fine print. They sat on condition pages, procedure pages, doctor bios and FAQs, exactly the pages a practice sends ad clicks to and AI Max reads first.
To be fair to these practices, much of it is accurate in context. A procedure that removes the root of an ingrown toenail edge really does stop that edge from growing back; "permanently" is the right word on the page. A surgeon's success rate may be real and sourced in the next sentence. The page has room for the caveat, the study and the line saying results differ from patient to patient.
A headline has 30 characters. AI Max can take the strongest words from a careful paragraph and leave the care behind. "Permanent Ingrown Toenail Fix" and "Painless Bunion Surgery" fit neatly in a headline, and neither carries the sentence that made them true.
Google's Rule Is About the Likely Result, Not the Best One
Google's ad policy on unreliable claims draws the line where this becomes a problem. The test Google applies is whether an ad dangles an unlikely result as if it were the normal one, and a result being possible somewhere doesn't pass it. It doesn't allow unproven claims of cures for incurable conditions. A patient story that names a specific result must also show, clearly, that other patients' results differ.
For a podiatry ad, that means the question isn't whether a result ever happens. It's whether the ad implies it's what this patient should expect. "99% Success Rate" in a headline, with no definition of success and no source, reads as a promise to the person clicking. So does "Painless" attached to surgery, when the patient will have a recovery.
Some claims have a second problem: they don't match what a treatment is actually approved to do. Laser treatment for toenail fungus is the clearest podiatry example, and it has its own chapter. Chapter 16 covers what those lasers are cleared for, and why "cure" is the wrong word for them. For now, the point is that AI Max doesn't check any of this. It reads the page, and the page is what it trusts.
Federal rules point the same way. The FTC's guidance on health claims says health benefits need competent and reliable scientific evidence behind them, and that tacking "results not typical" onto a dramatic testimonial doesn't fix a misleading one. A success rate on a website may be sourced in the paragraph below it; in an ad, that source is gone.
A practice that runs an ad Google considers an unreliable claim risks disapprovals and, if it keeps happening, trouble for the account. The practice is responsible for what its ads say, whoever typed them.
Twenty-Five Words and Forty Rules Keep the Claims Out
Google calls its two AI Max fences text guidelines, and a podiatry campaign needs both:
- Term exclusions: a list of as many as 25 banned words or phrases per campaign. Capital letters don't matter.
- Messaging restrictions: up to 40 sentences of instruction, such as "never promise a recovery time," for claims a single banned word can't catch.
Adding them to a running campaign reaches back, too: headlines Google already generated get checked against the new rules. Banned words are language-bound, though. If the practice runs Spanish ads (Chapter 9), the Spanish versions of each word need their own entries.
A podiatry starter set for term exclusions:
- Outcome words: cure, cured, permanent, permanently, painless, pain-free, guaranteed, eliminate
- Numbers and superlatives: 99%, 100%, #1, best
- Speed promises: instant, one visit, no downtime
- Treatment claims to keep off ads: stem cell, regenerate, FDA approved
- Prices: free, cheap, lowest
That's 21 entries, which leaves four slots for words specific to your own site, like the name of a device the practice uses that shouldn't appear in ads.
Messaging restrictions handle what single words can't. A few worth adding for any podiatry practice:
- Don't promise a specific result, recovery time or success rate.
- Don't describe any procedure as painless or risk-free.
- Don't say or imply that a treatment is covered by insurance or Medicare.
- Don't compare the practice or its doctors with named competitors.
- Keep the tone calm and plain; no urgency or hype.
- Don't include prices, for example $150 or $45. (Google notes that a "{{BODY}}quot; term exclusion can't stop prices; it has to be a messaging restriction, and an example helps it work.)
Adjust the list for your practice. If the practice really does offer a free consultation, "free" can come off the list; if the Medicare rules in Chapter 14 apply, keep that restriction.
Every Claim Fixed on the Page Is One AI Max Can't Borrow
Term exclusions catch the words you think of. They won't catch the ones you didn't. The more reliable fix is upstream: the pages themselves.
Before AI Max goes on, read the pages it will read, starting with every page the ads send people to. Look for the same things we counted on the 12 sites: cure, permanent, painless, percentages without a source, anything that sounds like a promise. A quick way to find them is to search Google for your own domain with the word, for example site:yourpractice.com "cure", and work through what comes back. Include the blog and the doctor bios; AI Max reads those too. Then rewrite the claim so it's still strong but carries its own qualifier. Have the doctor approve every rewrite. It's their name on the practice, their license behind the claim, and they know which outcomes are typical and which are the best case.
This helps well beyond AI Max. The same pages are the landing pages for every ad, the text Performance Max draws from (Chapter 10), and what patients read before they call. A page that promises less and explains more tends to set better expectations for the visit, and Chapter 8 showed that patients remember whether the doctor explained things honestly.
When the pages are clean and Exploration has steady conversions, test AI Max on Exploration alone. Keep Isolation exactly as it is, so the account has a controlled baseline to compare against, and change nothing else in Exploration during the test, so any change in results can be traced to AI Max. Watch three things for the first month: the search terms it adds, the headlines it writes (review the generated assets in the account) and the pages it sends clicks to. If a generated headline makes a claim you wouldn't make, add it to the exclusions and fix the page it came from.
If Google disapproves a generated asset for a health claim, don't just appeal it. Find the sentence on the site it came from, because the same sentence will keep producing new versions until the page changes.
If you'd rather have someone audit the site and set up AI Max's guardrails before it writes a word, that's how our Google Ads management team handles it for podiatry practices.
Next: What Medicare Will and Won't Pay For
Some of the most important claims in podiatry aren't about results at all. They're about coverage. Chapter 14 covers Medicare foot care: why a routine nail trim is covered for one senior and not the next, and why the ads can't promise either.
For the Local Services Ads decision, see Chapter 12. Every chapter is on the guide home.
