Medical marketing refers to direct-to-consumer advertising by doctors, hospitals, drug companies, and clinics (3). Medical marketing can be observed daily through television advertisements that promote pills and plastic surgery and posters directed at commuters on subways and buses. However, with the rise of the digital age, people are increasingly accessing health information through search engines and social media. Through these online avenues, medical marketing has the potential to make information about healthcare more accessible to the general public. However, the ethics of medical marketing remain unclear, and there is also potential for harm (3). Here, we explore the history of medical marketing and best practices for ethical healthcare advertisements.  

In order to be ethical, medical marketing must follow strict codes of ethics and guidelines set by medical boards and governmental organizations. In 1847, the American Medical Association’s Code of Ethics banned advertising for health care services, claiming that such practices undermined the “dignity of the profession” for physicians (5). At the time, the only legitimate ways for a physician to attract patients was through word of mouth from other patients or healthcare providers. In 1980, these restraints were lifted after a court determined that they restricted trade and commerce, and healthcare advertising has continued to grow since (5). To illustrate, in 2016, advertisers spent $10 billion on marketing medical services and prescription drugs (3). 

For most products that are advertised, such as food and clothing, consumers tend to possess an independent idea of their needs and what kind of service or item they are seeking (5). In contrast, patients looking for medical care cannot always form an independent understanding of their own needs because they lack the required medical knowledge and experience in the field (5). As a result, the informational imbalance between patients and healthcare institutions makes patients vulnerable to medical marketing, especially those who are seriously ill and seeking healing (5). This power dynamic between health care institutions and patients makes the ethics of medical marketing different from traditional advertising. 

In theory, healthcare marketing has the potential to reduce the stigma around conditions, such as HIV and depression, and educate patients about treatment options (1). However, there is little evidence that medical marketing, in its current form, provides meaningful information to consumers or contributes to lower prices or improved quality of care (4). According to one study, less than a quarter of all medical advertisements mention pricing or the quality of care—two factors necessary for patients to make an informed choice about their healthcare. 

Medical marketing also uses unethical tactics such as photoshopping before-and-after pictures of patients to make them appear “sicker” or “healthier” and collecting celebrity endorsements (1). These advertisements often fail to provide clear information on the risks of the procedures and treatments they promote and can create false hope in patients via unrealistic claims (1). Furthermore, marketing tactics can induce patients to seek out unnecessary treatments (5). Most of the advertised services tend to be more expensive, less common procedures; less costly, everyday procedures are promoted much less frequently (1). 

In order to remain ethical, medical marketing should adhere to the principles of ethics set forth by medical boards (6). These principles typically declare that marketing communications should not create unjustified expectations and should describe services exactly as they are offered (2). Furthermore, medical marketing should maintain patient anonymity and avoid undermining other colleagues. Healthcare advertisers should also take care to be mindful of populations who could be very vulnerable to the messaging (2). Through these practices, medical marketing has the potential to be used as a tool for health care providers and patients to build trust. 

References 

1. “How to Keep Health Care Marketing Ethical.” University of Nevada, Reno, onlinedegrees.unr.edu/blog/how-to-keep-health-care-marketing-ethical/ 
2. Gheorghe, Consuela Mădălina. “Is it deontologically correct to promote your medical services? An ethical approach on medical marketing.” Romanian journal of ophthalmology vol. 62,4 (2018): 251-252. 
3. Norton, Amy. “As Medical Marketing Soars, Is Regulation Needed?” HealthDay, 08 Jan 2019, consumer.healthday.com/general-health-information-16/doctor-news-206/as-medical-marketing-soars-is-regulation-needed-741288.html 
4. Park, Sung-Yeon et al. “US direct-to-consumer medical service advertisements fail to provide adequate information on quality and cost of care.” Journal of medical ethics, medethics-2020-106458. 26 Oct. 2020, doi:10.1136/medethics-2020-106458 
5. Schenker, Yael et al. “The ethics of advertising for health care services.” The American journal of bioethics : AJOB vol. 14,3 (2014): 34-43. doi:10.1080/15265161.2013.879943 
6. Solomon, Maria et al. “Ethical issues in advertising and promotion of medical units.” Romanian journal of ophthalmology vol. 60,4 (2016): 216-218.