Monday, February 7, 2011


Updated 3/2017-- photos and all links removed as many are no longer active and it was easier than checking each one.

I am old school and find it difficult to advertise. I don’t begrudge others who do so ethically and in good taste.
There is a local cosmetic surgeon who is running a special via TV ads and on his website (the photo is a screensaver shot of the website cropped to remove his name) that for me is unethical.

For me the ad “entices” potential patients into surgery without giving them information about potential risk.   Hopefully that information is given in detail when the patient is seen in the office consultation.
This was not an issue when I was in medical school (graduated in 1982).  I trained under surgeons who had never been allowed to advertised and frankly did not think doctors should. 
Deborah Sullivan, PhD has written a nice piece on the history of advertising in medicine, specifically cosmetic surgery:
Cosmetic surgery was re-commercialized in 1982. Before then, physicians, like other members of learned professions, were exempt from the 1890 Sherman Antitrust Act. The AMA could enforce bans on advertising because the fiduciary services physicians offered were not considered a commercial trade. Opinion changed in the deregulatory climate of the Reagan years. Hoping to bring down health care costs, the Federal Trade Commission sued the AMA for restraint of trade over their prohibition of advertising. Over the strenuous objections of the AMA and the plastic surgery specialty associations, a split Supreme Court decision let a lower court ruling in favor of the Federal Trade Commission stand [8, 9]. Advertising in medicine returned, with its ethical dilemmas, and cosmetic surgery was once again on the cutting edge.

As Dr. Sullivan notes (bold emphasis is mine)
The purpose of advertising is to persuade people to do something. The most effective ads appeal to emotions—fears and desires—and associate the subject of the advertisement with highly valued attributes. It is not difficult to persuade people to do something that will give them a more youthful, sexually attractive appearance in a culture that bestows real social and economic rewards on those who possess these traits. The lure of such rewards can make us gullible and impulsive when it comes to buying the promise of beauty.
There are a number of physician advertising practices that are deemed inappropriate (reference 2, 3, 5).  These include
  • Payment in exchange for referral of patients or media coverage
  • Exaggerated claims intended to create false expectations of favorable surgical results
  • Promotional inclusion of preoperative and postoperative photographs intended to misrepresent results through different lighting, expressions, or manipulated poses
I think Robert Aicher, Esq comments (reference 4)  regarding a surgeon’s web site could be extended to TV and print ads:
In this commentator’s view, ethical inferences from Web site to practitioner should be suspect. For instance, a former AMA member and Beverly Hills cosmetic surgeon, Dr. Jan Adams, surrendered his license to practice medicine on April 1, 2009, after it was suspended in 2008 for failure to pay child support, with prior alcohol-related convictions in 2003 and 2006. The November 10, 2007, death of his patient, Donda West, and his malpractice judgments of $217,337 and $250,000 in 2001 were not factors in his license surrender. Dr. Adams currently has an excellent Web site that makes no reference to any of these public records.  Accordingly, “quality” Internet advertising does not guarantee a quality practitioner, and conversely, patients routinely obtain quality results from cosmetic surgeons who do not have “quality” Web sites.
I’m all for educating the public.  I love the segments Dr. Anonymous does with his local TV stations for just that reason. 

1.  Advertising Cosmetic Surgery: The use of advertisements for cosmetic surgery has fluctuated throughout the twentieth century; Deborah A. Sullivan, PhD; Virtual Mentor. May 2010, Volume 12, Number 5: 407-411.
2.  Are Plastic Surgery Advertisements Conforming to the Ethical Codes of the American Society of Plastic Surgeons?; Spilson, Sandra V.; Chung, Kevin C.; Greenfield, Mary Lou V. H.; Walters, Madonna; Plastic & Reconstructive Surgery. 109(3):1181-1186, March 2002.
3.  The quality of Internet advertising in aesthetic surgery: an in-depth analysis; Wong WW, Camp MC, Camp JS, Gupta SC.; Aesthet Surg J. 2010 Sep 1;30(5):735-43.
4.  Commentary on "The quality of Internet advertising in aesthetic surgery: an in-depth analysis"; Aicher RH; Aesthet Surg J. 2010 Sep 1;30(5):744.
5.  ASPS Advertising Code of Ethics and Advertising 101 (in pdf form)
6.  Advertising cosmetic surgery: are doctors complying with ethical standards?; Australian Medical Association, June 2002

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