CHICAGO — Many of the nation’s top-ranked medical centers employ some of the same advertising techniques doctors often criticize drug companies for — concealing risks and playing on fear, vanity and other emotions to attract patients, a study found.
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The study of newspaper ads by 17 top-rated university medical centers highlights the conflict between serving public health and making money, the researchers said.
Some ads, especially those touting specific services, might create a sense of need in otherwise healthy patients and “seem to put the financial interests of the academic medical center ahead of the best interests of the patients,” they said.
Hospital officials defended their ads as fair, ethically sound and necessary in a competitive market.
The centers studied were on U.S. News & World Report’s 2002 honor roll of the nation’s best hospitals, including Johns Hopkins’ medical center, Harvard-affiliated Massachusetts General Hospital, the University of Chicago Hospitals and Vanderbilt University’s medical center.
'We do Botox!'
“We do Botox!” one analyzed ad proclaims. Another depicts a spilled cup of coffee symbolizing a woman’s heart attack — potentially evoking fear in a tactic more commonly associated with pharmaceutical ads than respected hospitals, said lead author Dr. Robin Larson, a researcher at the Veterans Affairs Medical Center in White River Junction, Vt.
Of 122 ads designed to attract patients and published in newspapers in 2002, 21 promoted specific services, including Botox anti-wrinkle injections and laser eye surgery. Only one of the 21 ads mentioned the risks. Most of the 122 ads — 62 percent — used an emotional appeal to attract patients.
One third used slogans focusing on technology, fostering a misperception that high-tech medicine is always better, the researchers said.
“As a result, patients may be given false hopes and unrealistic expectations,” they said.
As leading sources for specialized medical care, training and innovation, academic medical centers were selected “because we thought they would be the best-case scenario,” Larson said. “We thought if we find problems there, we would assume that they’re only worse” at community hospitals.
Pressures to attract patients
University medical centers generally are not-for-profit but still face financial pressures to attract patients and stay afloat.
Hospital advertising began about 20 years ago and grew as managed care increased competition among hospitals. The authors said it has risen among academic medical centers in the past decade.
Johns Hopkins spokeswoman Elaine Freeman said the study highlights an important point — that academic medical centers need to be sensitive to conflicts between money and altruism. But Freeman said that advertising helps educate the public and that Hopkins has a review process to make sure its ads are fair and balanced.
Vanderbilt spokesman Joel Lee also said his hospital’s ads are ethical, including the one featuring spilled coffee. He said that ad was intended to create awareness about women’s heart attack symptoms differing from men’s.
“Hospitals ought to be able to describe that they’re offering something of benefit,” Lee said.
University of Chicago Hospitals’ spokeswoman Catherine Gianaro said: “If any institution or company didn’t remain economically viable, they wouldn’t be able to serve the public health.”
American Hospital Association spokesman Rick Wade said that advertising is a necessity for hospitals, and that appealing to emotion is inherent in advertising. According to AHA guidelines, emotion-evoking ads are acceptable if they maintain “a proper sensitivity” toward vulnerable patients, and are fair and accurate, Wade said.
The guidelines also frown on ads for risky procedures that do not disclose the risks, he said.
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