Should medical professionals be allowed to advertise?

The advent of Internet has sparked off an ethical debate among the medical professionals on its use to further business. While a sizeable proportion of doctors stand opposed to advertising and publicity, the new generation medicos see no harm in utilising modern technology in their day to day practice. There is a wide consensus on the need to debate and redefine medical ethics. We present a few opinions on this issue.....

‘We need to harness the power of information technology’

R Bhattacharyya
Manager
Dr Agarwal’s Group of Eye Hospitals
Chennai

In today’s world of globalization and information explosion, the medical community cannot just remain inside a ‘shell,’ detached from the main stream. The profession of healthcare has all the ingredients of any other corporate industry and faces the challenges of ‘consumerism’. At this given situation, the healthcare community has no other option other than making their patient ‘aware’.

What are the tools available for keeping the consumers aware:

Use of information technology, starting from internet to telemedicine has got a significant role in keeping people ‘aware’. Today, patients are in search for the latest and best in the shortest possible time. This can only be achieved by harnessing more and more the power of information technology. I see no harm, if a doctor wishes to inform people about the services his clinic provides to the patients through the internet, infact it is a boon to the patient who would become more knowledgeable about healthcare and could make his best possible option.

In US there is no restriction on advertising medical services, but has it deteriorated the health status of US citizen? On the contrary our conservative approach to medical profession has not done much to the health status of our people when benchmarked against the best in the world. The medical community must welcome the information technology revolution, and use its positive implications which would help consumers (patients) to be ’better informed’ and lead them towards the right direction.

‘Services you offer should allow for transparency and auditing if required’

Dr Jayant G Mehta
Scientific director
Madras Medical Mission
Chennai

Throughout the world, IT has revolutionised the basic fabric of our society. Digital technology has also played a major role in our communications and with the availability of ISDN lines we can now transfer data from one part of the world to the other in few minutes as opposed to days.

Internet and web pages have been heralded as a single media which encourages our basic understanding in many subject matters and medicine is no different. It is therefore not surprising that some doctors may feel it appropriate to set up a web page on the Internet, offering their services and various different links to a particular disease or diseases which may be helpful and beneficial to the patients.

There is nothing wrong in advertising provided all the services you offer allow for transparency and auditing if and when required. I believe the new millennium should be viewed as the beginning of a much broader acceptance by the medicos of the potential of IT.

Making use of most recent information and technologies that are available for treating the patient for their betterment and providing the right choice of treatment at the appropriate time should be encouraged. Through website links, patients themselves can obtain information and question the rationale of the treatment being offered to them. Doctors like any other professionals have the right to justify utilising the information whether it may be through training Internet to their education profiles. I would therefore highly recommend that all doctors who have access to this service and are willing to participate, be encouraged to advertise their services and their expertise on the Internet.

’Doctors’ claims need to be authentic’

Vishal Bali
General manager
Wockhardt Hospital and Heart Institute
Bangalore

Advertising or expressing themselves through mass media is not unethical for medicos. It depends on the importance of what they want to say. There should be authenticity of what they are saying and a background of information against which they make certain comments.

If they are talking about certain new procedures or new method of doing things, they should have the entire scientific information of what they talk which is critical. Ultimately today patients have the right to know as to what are the new developments taking place as far as care is concerned, what is the new technology that is coming in and what are the new forms of treatment available to them, where are they being done and who is doing it. From this perspective there is nothing wrong if a doctor who has done some procedure for the first time talks about what he has done provided it should have relevant information behind it.

Whatever needs to be done should be done in a scientific way. A doctor must deliver scientific knowledge. We should see within what limits is the doctor talking about his achievements. There are some who do it often, some rarely and some do not do at all. There is nothing wrong if he speaks about his achievements but should not repeat the same thing. We need to see whether his achievement is ultimately beneficial for his patient population or whether his achievement has no relevance to the medical community at all. If the content of the information is highly relevant then, I think, there is no harm in sharing the information.

‘What is wrong if doctors advertise about their expertise?’

Dr Thomas Kalam
Director
St John’s National Academy of Health Services
Bangalore

There is nothing wrong in letting others know what one can do for them. In healthcare, the question is not whether ‘to advertise’ or ‘not to advertise’, but ‘how to advertise.’ Doctors should gain their reputation for their practice through their patients. They should be known by the quality of their services. Any other way of advertising is considered unethical in medical profession.

Professionals who have invested a lot in their training and want to recover the capital ploughed into the enterprise may not be always motivated by the desire for the well being of the patient. This is the beginning of a slippery slope. The person or organisation about to embark on the slope of advertising may promise to remain above board and be ethical. But unfortunately, the slope is such that once on it, the laws of physics dictate that whatever is on a slope must slide down, and at an ever increasing speed. This sums up why the Code of medical ethics forbids advertising.

‘Self-appraisal is something we cannot agree with’

Dr Sachdeva
President
Medical Council of India
New Delhi

There are certain circumstances when one may need to advertise viz. when a medico starts practising or changes the place of practice, etc. Besides, in case of a temporary absence from duty, then also he can inform about when he would be resuming duty.

As long as articles appear in the press profiling a particularly this particular camp is being organised by such and such hospital- then it is no advertisement on behalf of the individual or hospital. This is general news just like any other sector, not any advertisement. Even if someone else (for example a P.R. company) says it on his behalf it is fine. A doctor can keep on saying it for any time period he wants. As long as he doesn’t boast that he is the best doctor available or he provides a hundred per cent cure to a particular disease he is not doing anything unethical.

Printing of self photograph, sketches and diagrams, pictures of human system or any such material of publicity, in the letterhead or signboard of the consulting room or any such clinical establishment shall be regarded as an act of self advertisement and unethical conduct on the part of the physician. For example, if I put my photograph and with a sketch of the abdominal cavity then indirectly I am saying that I can do all this.

‘Doctor’s work is the best advertisement’

Dr Alok Sharma
Head, Dept. of Neurosurgery
LTMG Hospital & Medical College
Mumbai

The danger of allowing the doctors to advertise is that some of them may misuse the system. They can make claims that are exaggerated or not authentic. It may not be entirely false but at the same time, it may not entirely true either. And doctors who have the money power can exploit this avenue to make tall claims about their services. Thus the patients can be easily misled.

The only thing that the doctors should do to get their services recognised is to continue doing good work. Let your work be your advertisement. With good service, a doctor would naturally get recognition through word of mouth.

‘It is not a healthy trend’

Dr K R Shetty
Medical director
Cumballa Hill Heart Hospital & Research Institute
Mumbai

Doctors advertising about their services is not a healthy trend for the masses. Because the doctors can make claims which may not be true and thus the patients can be taken for a ride. But today even the patients have become smart and aware. They know where to go in case they fall sick. And they seek many people’s opinion before zeroing on a particular doctor or a hospital for their treatment.

‘The basic purpose of advertising must not be ’business-oriented’

Ram Nath Prasad
Hospital administrator
Sankalp Hospitals Private Limited
Jamnagar, Gujarat

Since services of a doctor or a hospital have to do with lives of the patient, the approach to the matter has to be different from what is seen in industries dealing with consumer and industrial items.

Limited advertising may be allowed subject to certain conditions:

• There should be a system of grading of doctors/hospitals. IMA is already working over the issue. Till the doctor attains a particular grade which can ensure his suitability to render medical services of his specialisation satisfactorily, he should not be allowed to advertise.

The meaning of term ’satisfactorily’ is relative and therefore, has to be defined suitably. Grading system should take into account the factors such as length of experience, number of patients seen, number of successes/failures and reason for the same, facilities available in the clinic/hospital, patient handling system etc.

• A doctor who has graduated fresh from the college must not be allowed to advertise. He should first learn his job under an established medical practitioner/hospital, gain a reasonable length of experience and prove himself capable of taking care of the patients independently, before he is allowed to advertise.
• Hospital rather than doctor (in individual capacity) should be encouraged to advertise. The hospital being a system will be more reliable.
• The contents of the advertisement must be factual and informative in nature. Unethical business practices with a motive of alluring the customers as practiced in other industries must not be allowed in health sector under any circumstances.
• Advertisement must specify what services a doctor/hospital can offer, stating the limitations too. It should leave no room for ambiguity. And therefore, the design of the advertisement is very important.
• The basic purpose of advertising must not be ’business-oriented’. Doctor should keep in mind that he deals with life and once it is lost, it is lost forever. Therefore, a doctor must not have business approach before advertising.

Since we are living in the world where everybody is after money irrespective of whether he deserves it or not and doctors, too, are in the race, a careful and well thought plan is needed before they are allowed to advertise.

The union health minister recently made a historic statement by declaring that doctors practising in government set ups cannot refuse to work in rural areas. He added that the government would bring in a legislation either in the coming parliament session or the next, to make rural service mandatory for doctors. We invite opinions on whether such a move should be made. Contributions can be sent at ehm@rediffmail.com by November 26, 2001.