Marketing your practice can cost tens of thousands of dollars. Is it money well spent?
Marketing and advertising in the medical profession have been undergoing a transformation in the past 15 years.
Until the late 1990s, medical practitioners were subject to tight restrictions, which meant they could do little more than advertise their address and opening hours. Any attempt to advertise special skills or services could result in a breach of the medical practice act in most states.
Today, medical practitioners use a variety of media to market and advertise their services to attract patients and referrals. But it is far from a free-for-all. Restrictions still apply (see Box 1) and doctors who overstep the mark can face the ultimate penalty of deregistration, as well as fines of up to $500 000 for individual doctors and penalties as high as $10 million for companies.
In the past 5–10 years websites have become the dominant marketing and advertising medium for medical practitioners, resulting in a major change in the way many patients access information (see Box 2).
Practices can pay tens of thousands of dollars for a professional marketing campaign and associated advertising, including the development of websites. But is it money well spent?
According to marketing academics, doctors are better off perfecting their service delivery rather than spending money on ad campaigns.
Simon Bell, professor of marketing at the University of Melbourne, says that because advertising and marketing by medical practitioners is regulated, the most effective way to drive patient traffic is word-of-mouth. “It is service quality that drives patient satisfaction, which leads to word-of-mouth referrals. Patient-to-patient referrals are the best form of advertising”, Professor Bell says.
The first question a doctor should ask is “what is the point of advertising?”, says Julian Vieceli, senior lecturer in marketing at Swinburne University, Melbourne.
Dr Vieceli says that instead of spending money on ads, finding ways to generate positive word-of-mouth referrals from both patients and colleagues is still recognised as the most effective medium for doctors who want to market themselves. He agrees with Professor Bell that service delivery and the attitude of the doctor and staff can have the biggest impact on the success of a practice.
“For [general practitioners] in particular, professional advertising campaigns are not going to make a huge difference to the practice”, Dr Vieceli says.
Both experts acknowledged that doctors starting out in a practice or who have moved to a new area do need to do some form of advertising or marketing.
However, for established practices in any specialty, the most important factors in “marketing” a practice are happy and helpful staff and running on time. “Most people can’t judge if the quality of clinical care offered is good, so it is the peripheral things that become important”, Dr Vieceli says.
Too much promotion?
There is also the risk of creating a negative impression by advertising. “The medical profession is held in different regard to most other professions, so when they advertise people wonder why”, he says. Too much promotion can make patients suspicious.
Professor Bell says that spending $100 000 on advertising will not work anyway if the medical practice ignores patients or is dismissive of their concerns.
Professor Bell says service quality comprises five key elements:
- Reliability, which for doctors means providing efficient and effective diagnoses
- Responsiveness, which means seeing patients on time
- Assurance, which involves a doctor’s expertise and ability to generate trust
- Tangibles, which cover the physical aspects of a practice such as cleanliness, facilities and the practice environment
1 Medical advertising: what's allowed?
THE Medical Board of Australia provides a comprehensive guide to what is acceptable and legal in marketing and advertising by medical practitioners. (See: “Guidelines for advertising of regulated health services” at http://www.medicalboard.gov.au/Codes-Guidelines-Policies.aspx)
The relevant section of the national law states that health services must not be advertised in a way that:
- Is false, misleading or deceptive or is likely to be misleading or deceptive
- Offers a gift, discount, or other inducement to attract a person to use the service or the business, unless the advertisement also sets out the terms and conditions of the offer
- Uses testimonials or purported testimonials about the service or business
- Creates an unreasonable expectation of beneficial treatment
- Directly or indirectly encourages the indiscriminate or unnecessary use of regulated health services.
The possible consequences of breaching advertising provisions include a finding of unprofessional conduct, which could lead to the cancellation of the doctor’s registration.
The Australian Competition and Consumer Commission also provides advice to professionals about the Competition and Consumer Act (formerly the Trade Practices Act) and a guide for the advertising or promotion of medical and health services (http://www.accc.gov.au/content/index.phtml/itemId/309070). It covers issues such as misleading and deceptive conduct, misrepresentation and false representation of services and costs, and unconscionable conduct.
It lists the most common problems with medical advertising as:
- Exaggerations or claims that cannot be substantiated
- Advertisements requiring or suggesting self-diagnosis
- Use of titles and qualifications
- Claims about price and/or cost
- Claims about time, eg. how quickly patients can expect results
- Disclosure of conflicts of interest
Penalties can be harsh if a doctor or medical practice breaches the act. Doctors may have to face court, pay fines, penalties or damages, refund money or run corrective advertising.
However, the ACCC says the most significant costs to a professional who breaches the act are lost practitioner and staff time, legal costs, and “loss of a hard-won professional reputation”.
2 Marketing online
DR Neville Steer says there are good reasons for medical practices to provide information to potential patients, especially when a framework exists that clearly outlines what doctors can and can’t say.
Dr Steer, a GP in Victoria and member of the Royal Australian College of General Practitioners’ national standing committee on GP advocacy and support, says providing information about changes at a practice, such as new doctors or services, and disseminating important details about community health risks, are legitimate reasons for doctors to advertise.
“If the information provided is honest and does not include testimonials or comparisons with other doctors, then I can’t see a problem”, he says. “But if a doctor claims to be the leading brain surgeon in Victoria, well that is going too far.”
Websites have rapidly become the most common form of advertising and marketing in the medical profession, Dr Steer says.
“Many specialists now have their own websites where they market directly to patients”, Dr Steer says. The result is that in the past 5–6 years the number of patients asking GPs for direct referrals to particular specialists has grown.
“Often requests are inappropriate, such as a dermatologist referral for routine skin checks or a gynaecologist for routine Pap tests in low-risk patients.”
“Some patients ignore the intellectual input of the GP and come to us only because under Medicare they need a referral to be eligible for a rebate”, Dr Steer says.
Dr Sara Bird, of MDA National, says although she does not have definite figures, there has been a noticeable increase in enquiries from doctors about their rights and obligations regarding the use of websites.
Dr Bird, the manager of medicolegal and advisory services, says there is an increasing expectation for doctors to have a website so people can find information.
However, she says the rules on what doctors can and can’t say on websites or when advertising are far from grey. “The rules are quite prescriptive”, she says, referring to the Medical Board of Australia and ACCC guidelines.
“Most doctors who do contact us do so because doctors are cautious by nature and don’t want to take any risks when setting up a website”, Dr Bird says. And in many cases breaches have been inadvertent, with a correction and apology usually adequate.
“Our advice is to be pre-emptive. Doctors should be aware of the medical board guidelines and of the trade practices legislation (Competition and Consumer Act 2010) before they start advertising or launch a website”, Dr Bird says.
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