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Should
hospitals be allowed to advertise?
Ankush
Gupta
 Advertisement
and promotion in healthcare industry was not acceptable, as
there was a question of moral as well as ethical authenticity
and accountability for the impact of an advertisement campaign.
It is now an age old debate that whether advertising in the
healthcare industry is ethical or unethical.
Advertising by the hospitals can be defined as “Utilisation
of proper media vehicles to send desired message to the community
in general and targeted clientele of the hospital services
doctors, patients, HMO, TPA in particular without offending
the moral, ethical and legal constraints of business promotion.”
Advertising and promotion are unethical in cases like, when
a dental doctor claims to improve the smile. As far as medical
professionals are concerned, code of ethics by IMA prevents
advertising and promotion of their skills by themselves or
by any institution on their behalf. Like Monopolies And Restrictive
Trade Practices Act, there is no law or frame work that defines
the ethical limitations applicable to the hospitals industry.
Advertising related to hospitals can be considered as unethical
when:
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It contains a misrepresentation of the fact or omits material
facts necessary to prevent deception or misrepresentation.
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It promises delivery of treatment or services by a pictorial
representation that cannot be experienced by other patients
by methods described.
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It claims to deliver the efficacy of services that does
not represent the typical experience of a patient.
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It claims that medical skills of doctors associated with
the hospital is better than the skills of any other doctor
with same set of medical degree, training and research unless
factually proved.
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It tends to create unjustified expectation of favourable
results.
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It takes undue advantage or creates fear or anxiety in the
mind of community.
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It misleadingly predicts that performance of a procedure
or delivery of treatment by a particular method will result
in satisfactory or expected outcome.
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It claims to provide services not permissible by law. (Eg:
termination of pregnancy governed by Medical Termination
of Pregnancy Act. Any organization that claims to do abortion
without following the previous of the act is doing it unethical).
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It is intended to attract customers by exaggerated claims.
Advertisement in hospital can be utilised to:
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Inform patients about the geographical location of an extension
of the existing hospital infrastructure like satellite clinics.
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Inform patients and doctors about the types of services
offered by the organisation.
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Inform patients about the different consultants providing
their services to community through hospital.
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Inform patients of any service offering that specifically
aims at preventive and promotive healthcare leading to benefit
of community in general.
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Inform patients, doctors of any service that is specifically
available only at the hospital in the geographical region.
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Any breakthrough medical procedure that claims to reduce
the disease prevalent rates in the community, provided this
type of claims are sustainable by factual, documented evidences
and approved by recognized medical association.
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Inform the community of quality of outcome through factual
supplementation of outcome.
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Inform the community about availability of services under
cover of health insurance provides/ reimbursement schemes/
TPA/HMO.
Major advertising decisions for a hospital:
After deciding to use advertising and promotional campaign
for the hospital, any hospital should address five major issues.
Advertising objective: Advertising can be utilised
for creating awareness and promoting one of the services or
for services of all the departments. A thorough analysis is
required to decide about the objectives of a particular advertising
campaign. The objectives can vary from providing information,
creating awareness, building brand or utilizing the services
of the hospital to optimal capacity. Advertising objective
has to be decided keeping in mind targeted clientele and also
service to be promoted. In case of a screening package, the
targeted market can be a client in the age group of 20-40
years, income group of Rs 20,000-40,000. The target clientele
is decided then the objective becomes crystalline to increase
the utilisation of screening package. The desired response
from advertising campaign has to be also defined such as increase
in the number of customers utilising that service, increase
in the number of customer inquiries exhibiting an increase
in the awareness, etc.
Advertising budget: Advertising budget is a very crucial
issue that should be addressed at priority because an advertising
campaign cannot be planned without proper input of funds.
The most common methods that can be utilised are:
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Objective based resource allocation: Based on the objectives
defined by the management, the advertising campaign can
be limited in terms of media vehicle selection, targeted
reach of message and also targeted clientele.
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Percentage of sales method: If campaigning is to be done
for a hospital service which is already generating a fixed
level of revenue then the budget allocation can also be
done based on the existing cash flows in the department.
This approach has certain limitations like the budget may
be insufficient to meet the actual requirement of the advertisment
campaign. Apart from this, a hospital must also have an
accounting system where revenue generation from each service
is accounted individually and market share of each service
should be clearly known.
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Supplementary resource method: In case a hospital introduces
a new service and there is no revenue generation, then the
service which has highest profitability can provide some
resource base to the new service. The hospital can also
supplement funds from marketing budget to help a newly introduced
service. This approach can be useful in case of services,
which do not generate sufficient revenues.
Message selection: Message selection for a hospital
is very difficult as the entire criticism of the campaign
depends upon the perception of the community. The success
of an advertising campaign depends on the factor that it communicates
the desired message to the community and does not cross the
legal, ethical and moral limitations. A more appropriate approach
can be using a demographic-service dimension grid. For example,
if a hospital wishes to develop message for communicating
services offered by the medicine department then demographic
segmentation plotted against service dimensions i.e. preventive,
promotive rehabilitative, restorative and curative can help
proper decision regarding message to community.
Media vehicle selection: Media selection is the next
vital step because selection is subjected to availability
of the budgeted funds, reach of the media vehicle and the
desired response. It becomes imperative for any hospital to
decide between media categories. i.e. print, broad casting,
electronic and display media. The use of print media is very
common in hospital industry in the form of brochures, leaflets,
pamphlets for disseminating information. The hospitals have
shown reluctance in utilising broad casting media though the
reach of this type of media vehicles is more than any other
media. However due to e-revolution hospitals have started
using web for hosting their websites and sites can be utilised
to send specific messages to community. Inside the hospital
premises, display boards at various locations for services
that are differential factors (USP) can be installed.
Impact of advertising: Hospitals have to put a lot
of effort to develop a mechanism by which they can really
estimate the overall impact of advertisement on the community
in general and hospitals in particular. If the advertisement
is meant only for purpose of creating awareness on a particular
ailment then being an institution accountable to the society,
it becomes mandatory to monitor that community is benefited
and morbidity, mortality and disease prevalence statistics
decrease. If it is meant to provide information regarding
hospital services then increase in the utilisation of these
services can be measured to evaluate return on investment
in advertising campaign. In case the objective is brand enhancement,
increase in brand equity can be assessed.
Hospitals have to come out of dilemma regarding the utilisation
of advertising strategies and intervention of Medical Council
of India, Indian Medical Association, and Indian Hospital
Association is required for drafting ethical and moral guidelines
for advertisements. Any organisation which violates these
guidelines, should be questioned and befitting action should
be taken. Use of advertising cannot be restricted as the number
of service providers is increasing, cost of infrastructure
is soaring and also the operational cost is on the rise. It
is better to develop a mechanism proactively rather then waiting
for unethical practices to flood the market place.
(The author is trainee, HR, P
D Hinduja Hospital, Mumbai and can be contacted at gupta_ankush11@hotmail.com)
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