I am old enough to remember when physicians did not advertise. It was considered a professional ethical issue. Hospital advertising consisted of institutional “We’re here” ads. Anything aggressive by docs or hospitals was considered bad taste… but that was before health care became as competitive as any other type of business.
I have been barraged, as have many of you, by a wave of hospital advertisements as our health care marketplaces consolidate and organizations seek to brand and differentiate themselves. We are subjected to print, radio, and TV ads extolling services, expensive technology, and that fact that each institution cares more than its competitors.
Charlie Rohlfing blogged recently about the worst in hospital advertising techniques, and you will recognize them all. They usually include a Da Vinci Robot and orthopedic surgery that will “get you back in the game.” They claim to be “state-of-the-art,” “leading edge,” or “cutting edge,” with actors playing doctors and nurses in masks.
The purpose of advertising in any industry is to expose potential customers to the services, products, and advantages of the organization or business in order to increase volume and, through competition, provide superior products at lower prices.
Nick Iannone wrote an excellent article about health care advertising, pointing out that, in the beginning of the 20th century, scientific proof became the barometer for measuring results in the medical field. Thus, in health care advertising, the traditional combination of product, price, and service isn’t strictly honored as it is for product advertising.
Hospital ad messages have two sides: one of “claims, procedures, and results,” reflecting the scientific aspect; the second is an emotional pitch, leveraging medicine as the art of healing. Hospitals do try to use objective statistics in their advertising messages when possible; their marketing messages are also part public education and confidence-building. But health care organizations commonly leverage emotional stories to show they care and that their staffs are dedicated and compassionate.
There is minimal oversight of hospital marketing compared with the active role the FDA plays guiding the direction of advertising for food and drugs. Specific advertising rules are enforced to ensure that the outcome is a better consumer understanding of a prescription drug’s risks and benefits. Homeopathic remedies and food companies are also under scrutiny by the FDA. Recently, General Mills was severely criticized for wording on its Cheerios box that states that the cereal is “heart-healthy” and could lower cholesterol by 4 percent in only six weeks. Coca-Cola has also been scolded by the FDA and sued for claims made about its VitaminWater beverages. I wonder what the FDA would say about some of our hospital marketing: Does it educate the consumer?
Potential patients are susceptible to our advertising only when they have a medical need. Women notice labor and delivery ads from hospitals only when they are planning a family. Advanced cardiac service ads are noticed by people who have a cardiac disease or have a family member who has coronary artery disease. The health care marketplace is complicated by the fact that market sensitivity is directly associated with disease prevalence. As a result, hospitals are spending more on advertising than they have in years, as they fight for market share and margins in a time of shrinking reimbursement, declining admissions, and health care consumerism.
Dwayne Waite reported that while other industries are shrinking advertising budgets, advertising spending for hospitals rose 20 percent, to $717.2 million, just in the first half of the year. This is a marked difference from 2008-2009, when marketing spend decreased 10 percent. Hospitals are increasing their investment in advertising in an attempt to differentiate themselves in a competitive environment in which patients are playing a more active role in their health care. Hospitals are marketing specific services and outpatient treatments as well as consolidations that have formed more comprehensive health systems. For most hospitals, the marketing buy is $1.3 million to $6 million annually. This expense is seen as necessary in today’s market, although most CEOs would rather repurpose these dollars for programs.
If we could reinvent how we share our services and results in a more cost-effective way, what would we do? Should we make our medical staff performance and hospital quality outcomes publicly available for the services that we feel distinguish our institutions? Because we know that consumer decisions are both rational (based on statistics) and emotional (based on perception of care and compassion), we should include testimonials. That sounds like a hybrid of Hospital and Physician Compare, US News and World Report rankings, and HCAP scores combined! Better yet, if we could target and market services to consumers for age-specific diseases, or leverage data about purchases that reveal their need for our specialty services, we could segment and connect with consumers more efficiently.
If we really used technology creatively and courageously, we would create an information aggregator that pulls data on hospital and physician quality and service that allows consumers to search and compare. Instead, we have created a huge federal infrastructure in Hospital and Physician Compare that is clunky and user-unfriendly. We don’t really know what patients want to know when they make their health care decisions, which vary with their individual preferences and medical needs. What would we discover if we let patients show us how they make decisions by tracking their searches in a broad database?
Maybe we don’t need to put the genie back in the bottle, but instead should give him a modern makeover.
Joanne Conroy is chief health care officer, Association of American Medical Colleges. She blogs at Wing of Zock and can be reached on Twitter @joanneconroymd.