Hospitals in advertising arena must tread fine line
Marketing can hurt or benefit consumers
Like any other businesses in a competitive market, hospitals are investing heavily in advertising; but hospitals are held to a different standard than supermarkets and car dealerships when it comes to vying for customers.
"We’re fond of referring to health care as an industry," says Bill Stiles, president of Adcuity, an Atlanta-based hospital marketing and advertising company, and a past officer of the Society for Healthcare Strategy and Market Development. "It’s an industry like no other."
With the strong emergence of for-profit hospitals in the 1980s and 1990s, hospital advertising became commonplace. Though consumerism was not new to health care, he reports, the new competition from for-profit institutions thrust hospitals into the world of marketing and advertising.
As hospital advertising became more commonplace, concern grew that the level of trust patients placed in physicians and hospitals could be compromised if the messages conveyed in advertisements were not managed carefully.
Advertising part of marketing plan
Advertising was discouraged by the American Medical Association (AMA), which feared advertisements could be at odds with Hippocratic ideals. In the late 1970s, the AMA policy was struck down by the Supreme Court as a violation of free speech, but what has remained is an agreement throughout health care that the trust between physician and patients should not be broken by misleading advertising and that encouraging unneeded treatment is unethical.
Stiles says advertisements that provide fact-based information about health issues or services available through a particular hospital are good for patients; ads meant to create demand, however, sometimes toe ethical lines.
"Advertising is just one tool in a hospital marketing plan, but in general it’s the part that the consumer is most likely to see," he explains.
And if what consumers see frightens them into believing that they need medical treatments that they really do not, or leads them to believe that care received at any other hospital would put them at risk, for example, the consumer is harmed, Stiles and others say.
"Marketing and advertising can be good for the consumer, but that’s not always the case," says Stiles. "A lot of advertising is misapplied."
Good advertising, he says, educates and informs in a credible way and promotes the use of a hospital’s services.
"You can satisfy those points, and be appropriate and ethical, and in that way, advertising can be good for the community," he continues. "But you can find a fuzzy line and see some advertising that makes you wonder if it is really communicating useful, credible information. You can find examples on both sides of the line."
He says two styles of advertising that bother him are those that imply an unrealistic expectation of recovery and those that suggest that if the patient uses a particular provider or hospital their chances of success are improved.
"If you can back that up and provide widely accepted documentation that you are making a factual claim then fine," Stiles says.
Bad ads diminish respect
The American Hospital Association (AHA) has guidelines for hospital advertising that urge hospitals to be especially careful when using emotion-evoking advertising.
Such ads are acceptable by AHA standards if they maintain an appropriate sensitivity toward vulnerable patients, are fair and accurate, and don’t play on patient fears.
AHA supports use of advertising to advance the health care organization’s goals and objectives, educate the public, report to the community, increase awareness of available services, and recruit employees. The association urges that health care advertising be truthful, fair, accurate, complete, and sensitive to the health care needs of the public.
"False or misleading statements, or statements that might lead the uninformed to draw false conclusions about the health care facility, its competitors, or other health care providers, are unacceptable and unethical," according to the AHA guidelines.
The guidelines also warn against the use of advertising for procedures that do not disclose risks attached to those procedures.
A study by researchers at the Veterans Affairs Medical Center in White River Junction, VT, that appeared in the March issue of Archives of Internal Medicine1 found that some of the top-ranked medical centers in the United States used ad techniques that concealed risks and played on fears to attract patients.
Some ads, the study’s authors found, could cause healthy patients to feel they need to seek out services, and appeared to put the financial interests of the medical centers ahead of patients’ best interests. The study took place in 2002 and looked at advertising placed by 17 hospitals that appeared that year on U.S. News & World Report’s list of the nation’s best hospitals.
"If a car dealer comes on and says, We’re No. 1,’ you don’t pay that much attention to it, but when you start to get into health care, you have to hold hospitals and physicians to higher standards, and that’s perfectly reasonable to do," says Stiles. "Hospitals run the risk of diminishing themselves in the eyes of the consumer if they act too much like car dealers or other typical advertisers. It starts to lower consumers’ respect for hospitals and physicians."
Although few hospitals even had marketing departments 30 years ago, today health care is a booming area in the advertising industry. Between 1992 and 1995, according to the Evanston, IL-based market research firm Quality Expectations, spending on major media ads by hospitals, insurers, and physicians increased 117%.
Physicians, too, are entering the advertising arena, buying air time and print advertising — steps doctors never took even two decades ago.
"I see physicians currently at the point [in marketing] where hospitals were about 20 years ago, in terms of their awakening interest and motivation in advertising themselves," Stiles says. "It’s not just large groups of physicians, but individual doctors who are more inclined to market themselves and advertise."
While advertising might drive more business their way, Stiles, who has worked in hospital marketing and consulting for 30 years, predicts there will be a loss of the lofty esteem in which hospitals and physicians have historically been held.
"As time goes by, one of the things we’re likely to see is hospitals and health care providers being held in increasingly lower esteem, and their marketing practice has a role in that," he states. "If health care is seen as a commodity that’s bought and sold, it changes how the public looks at providers."
Reference
- Larson RJ, Schwartz LM, Woloshin S, et al. Advertising by academic medical centers. Arch Intern Med 2005; 165:645-651.
Sources
- Bill Stiles, President, Adcuity, 1201 Peachtree St., 400 Colony Square, Suite 1250, Atlanta, GA 30361. Phone: (404) 591-2642. E-mail: [email protected].
- American Hospital Association, One North Franklin, Chicago, IL 60606. Phone: (312) 422-3000. Ethical Conduct for Health Care Institutions available on-line at www.hospitalconnect.com/aha/resource_center/resource/resource_ethics.html.
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