Ethical Marketing and Advertising in Ophthalmology

Competition is on the rise in healthcare. Especially as reimbursements decrease for many ophthalmic procedures, more ophthalmologists are turning to marketing to attract more patients, increase revenue, and stay competitive. Many ophthalmologists rely on marketing agencies rather than performing marketing activities in-house, and it’s all to easy for physicians to form opinions of effective marketing strategies based on what they have seen their competitors say and do.

While the pressure to remain competitive amidst a changing landscape is certainly powerful, ophthalmologists must maintain an ethical approach to advertising, especially in healthcare, where high stakes and occasional mismatches between patient expectations and surgical realities can vary drastically and have serious consequences.

Business Values vs. Medical Values

There’s no doubt that ophthalmic marketing is on the rise, especially in recent years. The benefits of refractive surgery tell a good story, and the procedure itself is lucrative for physicians – why would an ophthalmologist not want to advertise?

However, with the advent of modern marketing technologies, one must pay careful attention to the message of the ad itself, ensuring that what is being claimed can actually stand up to the likely outcome of a procedure. The most effective forms of marketing get the target to focus on perceived value from buying a product or a service rather than focusing on the attributes of the product or service itself. However, in healthcare, the rules are a bit different.

“First, do no harm.”

In short, one must be careful about confusing business goals with medical obligations.

Traditional business values focus on increasing revenue, attracting new patients, and growing a business, sometimes by whatever means necessary. This doesn’t mean that all business-related activities are inherently unethical, but the line can easily be blurred by the siren’s call of increased revenues and practice growth, no matter the cost.

Contrast those capitalistic values to the values of the medical practitioner, whose primary duty and obligation is not to the practice, but to the patient: first, do no harm. These ethical values are not always in alignment with the cutthroat strategies espoused by traditional business values. It’s tempting to replicate what the less-than-ethical practice across town is doing because it seems to be working so well for them – but this is where the ethical physician must question the the underlying values at play.

An Ethical Approach to Marketing: The Rules

Advertising ethics in the medical profession have changed dramatically over the past 50 years. Advertising became popular and gained legitimacy in 1982 when the Federal Trade Commission won its lawsuit against the AMA, who had previously restricted advertising in its Code of Ethics.

While many ethics and best practices of ethical advertising are still regulated by the Codes of Ethics of many medical governing bodies, there has been a gradual acceptance of the presence (and necessity) of traditional marketing in recent years. Medical associations and professional organizations understand that marketing is here to stay, and that many specialists such as ophthalmologists are keen to employ its strategies to their benefit.

At its core, the rules are simple: marketing and advertising (for sake of discussion, we use the terms interchangeably) are designed to sell a core product or a service. In other fields, claims of superiority of one product or service over another are thrown around all the time, and often cannot be verified (are Bounty paper towels *really* 60% more absorbent?). But for many products and services, the stakes are relatively low: will your life really change that much if it turns out Bounty is only 40% more absorbent? Probably not.

This is where physicians have to tread lightly. Claims of superiority of a product or service in the medical arena can easily come into conflict with a physician’s primary obligation to the patient. In healthcare, marketers may focus on potential benefits of certain procedures such as LASIK rather than simple product attributes, but advertisements “must not contain material claims of superiority that cannot be substantiated.”

According to the Code of Ethics of the American Association of Ophthalmology, communications to patients (which encompass marketing in its various forms) “must not convey false, untrue, deceptive, or misleading information through statements, testimonials, photographs, graphics or other means. Communications must not appeal to an individual’s anxiety in an excessive or unfair way; and they must not create unjustified expectations of results.”

The absorption of paper towels may not change a patient’s life, but if they fall prey to less-than-ethical claims about a medical procedure, there’s more at stake. Ethical conduct in marketing is key.

The Scales Will Even Out

Although new forms of marketing brought about by new advertising technologies are on the rise, we cannot underestimate the power of word-of-mouth marketing, either. Remember the last time you were burned by a product or experience? What did you tell your family and friends about it? Chances are you wanted to warn those in your inner circle of your disappointing experience, lest they repeat your mistake.

In the same way, patients who fall prey to less-than-scrupulous physicians who employ deceptive marketing techniques are more likely to disparage their services online and to their peers. In today’s economy, which is highly driven by authentic stories and recommendations from trusted sources, this can make or break a practice. If you’re tempted to worry about competitors who are focusing their efforts on less-than-ethical marketing strategies (to their benefit), don’t bother. Their day will come.

The Responsibilities of the Physician…and the Marketer

At the end of the day, the physician’s ultimate responsibility is to the patient: did they accurately portray the service offered? Did they deliver a good experience that met the patient’s expectations? Did they, to the best of their ability, provide adequate, compassionate medical care and do no harm?

While it may seem incongruous at first, the marketing agency’s ultimate responsibility is not to physicians, but to patients. Yes, marketing agencies have to account for performance, showing their clients how their services are adding to the bottom line, but their obligation is deeper than that. The end goal is not only to increase revenue and attract more patients, but to establish a human connection between the physician and patient, ensuring a good experience. If marketing agencies do their job well, revenue will naturally flow to their clients as a result. If marketers are serving patients, they will be serving physicians, too.

Not only does ethical behavior in ophthalmic marketing reduce the risk of malpractice litigation, but it will enhance the reputation of those practices who employ ethical marketing practices in a field where competitors’ claims may not hold water.

While the medical landscape is changing and reimbursements are declining, the prudent ophthalmologist must keep in mind the overall goal of delivering exceptional patient care in the increasingly-complex healthcare puzzle.

Ethical marketing is just one a piece of it.

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