By now Americans are accustomed to seeing advertisements for medical goods and services. The steady supply of direct-to-consumer TV advertisements by the pharmaceutical industry is probably the most high-profile example. But while much has been written about the negative effects of these advertisements, the impact of healthcare service advertising---by hospitals as well as by individual physicians---receives comparatively little attention and almost no debate.
A survey of hospitals from the Archives of Internal Medicine a couple of years ago, referenced in Oxman’s article, uncovered conflicts of interest, non-evidence based promotions, disease promotion and “freebies”. Worse, these promotions were found in 16 of the 17 “America’s Best Hospitals”.
To me it’s a case of the pot calling the kettle black as physician leaders at these and other academic medical centers talk about “professionalism” and rail against pharmaceutical industry promotion while tolerating such ethical breaches by their own institutions.
That may be changing. In yesterday’s issue of JAMA, faculty from two medical centers addressed a novel aspect of self-promotion: hospitals, eager to take advantage of rising public interest in quality and transparency, are now couching their promotions in scientific terms by presenting them as “data”. The problem is they are doing this independently of any form of external validation, without appropriate statistical analysis and with bias.
Dr. Robert Wachter, one of the paper’s authors, talks about it on his blog.