The authors surveyed marketing departments of 17 top rated (by US News and World Report) AHCs to assess the process used to construct advertisements. They then searched for print advertisements placed by the AHCs in local newspapers, and did a structured assessment of each ad.
Let me quote from their results section (with italics added for emphasis). First, the process of development and approval of the ads was almost never supervised by physicians:
- "About two thirds of the marketing department representatives were familiar with their institutional review board's process for assuring fair, balanced, and straightforward content in advertising to attract research participants. None of the marketing departments had a similar process for reviewing ads to attract patients for health services."
- "Only 1 center had a mechanism in place for obtaining medical approval from a person outside the department being advertised."
- The ads promoted dubious services, "Of the 21 ads for single [clinical] services,.... 19 single-service advertisements were for procedures considered cosmetic ..., having limited (or no) efficacy data, ... or lacking consensus."
- The ads played on patients' emotions, "Most of the institutions' slogans emphasized cutting-edge care and institution status.... The remaining slogans tended to use emotional themes." "Advertising headlines ... commonly mentioned symptoms or diseases or used strategies that might appeal to patients' emotions or fears."
- The ads exaggerated benefits while avoiding mention of harms, "While more than three quarters of the single-service ads highlighted potential benefits of the services promoted... none quantified their positive claims. Only 1 ad mentioned or implied potential harms of the service...."
- "Given the prestige of academic medical centers ... consumers may have great confidence in the quality , accuracy, and underlying altruistic motivations of any information with which the institutions are associated. Because of this trust, consumers may not recognize the different between information intended to inform the public and advertising designed to generate revenue."
- "Second, many of the ads seemed to foster the perception that more and higher-technology medicine is always better." "As a result, patients may be given false hopes and unrealistic expectations."
- "If academic medical centers are to continue with advertising to attract patients, we believe they must be more sensitive to the conflict of interest between public health and making money."
- "Many of the ads seem to place the interests of the medical center before the interests of the patients."