Academic medical centers are relying more on advertising to attract patients. However, because there is little oversight of these practices, many ads seem to place the interests of the medical center above the interests of the patients, a new study contends.

An internal review process would help ensure that the interests of patients are protected, the study suggests.

"We're not looking for huge regulation of medical centers and we don't necessarily think they shouldn't advertise at all," says lead author Dr. Robin Larson, clinical researcher with the VA Outcomes Group at the Veterans Affairs Medical Center in White River Junction, Vermont. But, she adds, there are things the medical centers can do to make the advertising better.

The Study

To try to characterize ads aimed at attracting patients, the study looked at all 2002 non-research print ads in the five most widely circulating local newspapers for the 17 academic medical centers included in US News & World Report's annual list of "America's Best Hospitals.

The authors also interviewed members of the hospital's marketing departments about their advertising practices.

Of the 17 institutions, which included Johns Hopkins in Baltimore and the Mayo Clinic in Minnesota, 16 reported advertising to attract patients.

Of 127 print ads not related to recruiting participants for clinical trials, three promoted community events sponsored by the institution and two announced "genuine" public services.

The remaining 122 were aimed at attracting patients. Of those, 30% (36 ads) promoted the entire medical center, 53% 65 ads) promoted specific departments and 17% (21 ads) promoted single tests or interventions—many for cosmetic procedures. More than half of the ads for the cosmetic procedures outlined the benefits, but only one mentioned potential dangers, the study found.

Attracting Patients

The most popular marketing strategies include appealing to emotions, highlighting the prestige of the institution, singling out a symptom or disease and promoting introductory lectures or special offers, including complimentary health screenings and first-aid kits.

And although all 17 centers said they had an institutional review board to approve advertising to attract research subjects, none had a similar process in place for ads that were designed to attract patients.

Some feel that oversight of this type of advertising should be more stringent.

"Advertising is a form of propaganda. It attempts to bypass the viewer's or listener's rationality and get people to respond to things emotionally, to instill needs where needs might not exist, to make people feel comfortable when they have no idea what it's really about," says Paul Levinson, chairman of the department of communications and media studies at Fordham University in New York City.

"It's fine when it comes to cereal or even automobiles; it's fine when it comes to clothing and perfume. It's not fine when it comes to hospitals."

Ads by medical centers, which reflect an increasingly competitive health-care market, have not been analyzed as closely as direct-to-consumer advertising of prescription drugs.

Opinions Vary On The Next Step

Larson believes an internal review process might be a way to instill standards in advertising, "My sense is the medical centers want to do the right thing," she says.

But Levinson believes these ads should be banned. "What ads are designed to do through images and music is to get people to feel good about these products. That's not appropriate when dealing with medical situations. I'm against FCC [Federal Communications Commission] control of the media, but this is one of the few instances where I think the government has to step in and stop these ads," Levinson says.

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