Have you ever watched television during the day? When I was much younger I recall staying home sick and one of the pleasures (aside from getting to eat Popsicles) was getting to watch black and white re-runs of 1950s television shows such as “My Three Sons” and “The Real McCoys.” Now, daytime fare seems to be geared towards ex-judges making pronouncements regarding the courtroom decorum (the favorite of the break room  this week is someone called “Judge Pirro”).  I don’t get to sit through much of the programming but if I did I understand I would see these commercials:

I now know all about Binder & Binder, America’s most trusted social security disability advocates. I know about Colonial Penn life insurance: they won’t reject your application because of age (even if you’re over 50), don’t require a medical examination, and is only $0.35 a day. And don’t forget the SunSetter retractable awning that makes it so you can enjoy the outdoors without baking in the sun.

Many of the daytime commercials (there are also a lot for medications related to osteoporosis, cancer, and erectile dysfunction)  contain the television commercial of equivalent of fine print, that rapidly read or speedily scrolled disclaimer that allows the advertiser to comply with the letter if not the spirit of what (I supppose) is a legal requirement to inform the public that what is being said in the ad is at best a half truth.

I bring this up because it surprises me that while lawyers are required to tell us that because they can purchase air time it in no way implies that they are any good at lawyering, medical professionals are under no such compunction. In fact, there is evidence that misrepresentation in ads for medical services is not uncommon and they are designed to:

  1. Manipulate patients’ ignorance and vulnerability; and
  2. Stimulate demand for unproven or ineffective therapies

Academic health centers were no better than their less academic colleagues:

In a study of advertisements produced for academic medical centers, Larson and colleagues found that more than 60% of the advertisements directly appealed to patients’ emotions. Further, the same study found that medical centers consistently promoted procedures or therapies with unproven benefits.

So what, you say. We are exposed to ads in a number of settings and for a number of products. Why not health care? Aside from the fact that many health care decisions are made under duress, the author of the article on medical advertising also points out that:

In the majority of circumstances, the consumer of healthcare services can’t truly be informed about what he or she is buying. Assessing the efficacy and safety of medical treatments requires time, reflection, and often expertise that most patients don’t have. Even if their sponsors’ intentions are honorable it is extremely difficult for medical service advertisements to convey the complex risks-and-benefits ratios that underlie intelligent medical decision-making. Complicating matters further, indicators of quality in medicine are extremely difficult to assess for the healthcare professional—let alone the layperson. As one author has put it, “the sheer complexity of medicine, and the quality measures it has available, virtually guarantees that any statement about quality that can fit comfortably in a popular advertising format will be deceptive … .”

What to do? One solution would be to require “fine print.” There is a web site where data for each hospital is available. Known as Hospital Compare,  it takes data from Medicare patients’ experience and uses it to compare hospitals to state and national benchmarks. It includes information regarding the process of care (how many patients get appropriate antibiotics), the outcomes of care (death rates for certain illnesses), the use of imaging studies (does you hospital order too few? Too many?) and patient satisfaction (would you recommend this hospital to a friend). Requiring inclusion of this type of comparison information in an advertisement would allow the consumer to compare hospitals based on information that is non-biased and data driven. Hospitals would at least have to use creativity to make their shortcoming appear as advantages, as Cialis did with a certain 4 hour problem. At the very least it would allow the consumer to make a more informed choice, like we do when we pick a lawyer based on the quality of the television ad.