For compliance and outreach teams in the healthcare space, the Federal Trade Commission’s Do Not Call (DNC) database has long been a familiar constraint. But new complaint data reveals a trend that demands closer attention: medical and prescription-related calls are no longer just a notable category — they are the single largest source of DNC complaints in the country.

Understanding this trend isn’t just about avoiding regulatory exposure. It points to a deeper tension between the need for proactive patient outreach and the erosion of trust in unrecognized calls — a problem that is most acute in the communities that healthcare organizations most need to reach.

A consistent climb to the top

Medical and prescription calls have ranked in the top three DNC complaint categories every year from 2022 through 2025, reaching the top spot in FY 2024. The complaints span both robocalls and live agent calls — and both categories have grown steadily over this period.

Source: FTC Do Not Call complaint database. Includes both robocalls and live calls.

The scale of growth is significant. Total complaints in this category rose from 133,300 in FY 2021 to 204,300 in FY 2025 — a 53% increase in just four years. In FY 2024 alone, volume jumped to 170,000 before surging again the following year, suggesting the trend is accelerating rather than plateauing.

Why this matters for healthcare organizations

Not every call that generates a DNC complaint is a bad-faith one. Legitimate patient outreach, prescription reminders, health surveys, and care coordination calls can all trigger complaints when recipients don’t recognize the caller or context. Each complaint represents a missed connection — and potentially a missed care opportunity.

The states with the sharpest increases

The growth in complaints is not evenly distributed. Certain states have seen dramatically higher increases — and the pattern is telling.

West Virginia leads all states with a 192% increase — the highest in the country. What makes this pattern particularly significant is its correlation with state health rankings. West Virginia ranked last (50th) in a 2025 survey of US state health outcomes. Mississippi, Arkansas, Georgia, and Missouri — the other states with the highest complaint growth — all ranked 34th or lower in the same survey.

The trust gap in high-need markets

States with the highest rates of chronic disease and poor health outcomes are also the states generating the most DNC complaint growth. These communities are arguably the ones most likely to benefit from proactive healthcare outreach — but also the least likely to trust an unrecognized call. On the other side, states that saw the most decrease in complaints all ranked 24th or higher in state health outcomes. Where healthcare need is greatest, the communication gap is widest.

Complaints don’t always mean wrongdoing

It is important to place this data in context. The federal DNC database captures complaints across a broad range of call types — including surveys, which are exempt from certain DNC restrictions but may still be perceived as unwanted by recipients. A healthcare organization conducting post-discharge surveys, medication adherence outreach, or care gap closure calls may find itself generating complaints from patients who simply didn’t recognize the number or understand the purpose of the call.

This means the complaint volume likely overstates actual DNC violations while still reflecting a real and measurable problem: healthcare organizations are not breaking through. Whether the call is technically compliant or not, a complaint is a signal that the communication failed.

What healthcare and compliance teams should consider

The data points to several areas worth examining for organizations that conduct outbound calls to patients or members:

• Caller ID and brand recognition: Patients who don’t recognize a number are more likely to file a complaint regardless of call legitimacy. Verified caller ID solutions and branded call display can meaningfully reduce complaint rates by giving recipients context before they answer.
• Consent and preference management: Ensuring that call programs are built on clear, documented consent — and that patients can easily express and update communication preferences — reduces both complaint volume and regulatory risk.
• Geographic targeting and risk stratification: Given the state-level patterns in this data, compliance teams may benefit from a closer look at call programs in high-growth complaint states — not to pull back outreach, but to apply additional care around consent verification and contact strategies in those markets.
• Survey exemptions and documentation: Organizations conducting surveys or research calls that fall under DNC exemptions should ensure those exemptions are well-documented and that call scripts clearly identify the purpose of the call early, reducing the likelihood that a compliant call still generates a complaint.

The rise in medical and prescription DNC complaints is a data story — but underneath it is a patient trust story. For healthcare organizations navigating outreach compliance, the challenge is not simply staying on the right side of the law. It is earning enough recognition and trust that the people who need to hear from you actually listen.