HOSPITALS: Growing Ad Trend Raises Ethical Concerns
"Facing competitive pressure to keep beds full, and in an era of heightened consumer awareness about health care, hospitals have drastically increased their advertising in the past two years" -- a trend now under scrutiny by health care ethicists and the American Health Association. The Boston Globe reports that hospitals nationwide allocated a "staggering $1.28 billion" to advertisements last year, representing a 32% increase over the previous year. The Opinion Research Corporation International found that the average hospital expenditure on advertising last year was $257,800. This figure compares with $195,100 in 1996 and a "virtually nonexistent" advertising budget in 1984. Skeptical of the growing trend, health professionals warn that advertising money "carved out of a budget otherwise devoted to saving lives" should be subject to guidelines. Others are more critical. Boston University School of Public Health professor Alan Sager calls hospital ads a "pathetic waste of money." Others raise concerns about "survival story" advertisements, which portray a former patient as a hospital's success story and testify to the skill of the facility's physicians. The Globe notes that such concerns prompt a number of ethical questions: "How much can a hospital truly promise? When does a survival story become misleading? And where, in a market bound to grow only more competitive, should Madison Avenue stop?" The American Hospital Association plans to address these concerns and provide new guidelines for its 4,600 members. Susan Dubuque, president of the health care consulting firm Marketing Strategies Inc., sums up the controversial matter, saying, "You're not dealing with hamburgers. You're not dealing with cosmetics."
A 'Human Institution'?
Hospital officials respond that the advertisements are influential in patient recruitment for specialty fields at a given hospital. Scott Cheyne, senior vice president of the marketing firm holding the advertising account for Boston's Dana-Farber/Partners Cancer Care, said, "We find that people go to a hospital for a specific purpose ... as opposed to walking in the front door." Joan Fallon, spokesperson for the New England Medical Center, said that the hospital's ad campaign increases public awareness "of the services we provide. Doctors were urging us to advertise." The Globe notes that many patients also endorse the marketing strategy, discrediting claims that the advertisements exploit patients and perhaps are not forthright about possible outcomes. New England cancer patient Leonard Zakim said, "I don't' think they're exploiting it. ... The care was great. But I would make sure there was some kind of disclaimer. I would say that every case is an individual case." However, "in part because the border between intense testimonials and outright promises has grown so hazy in recent years," the AHA "has decided to spend the next few months revising its ethics guidelines for advertising campaigns." Rick Wade, AHA senior vice president for communications, said, "We have repeated to our members over and over again, urged them not to get into the claim that one hospital is better than the other." He added, "We are human institutions, our performance is judged day by day, minute to minute" (Kornblut, 8/25).