No to medical advertising

altWe have said it before, and we have to say it again, since the Government has no rationale at all for allowing the medical profession and their institutions, whether general or specialist clinics or private medical centres, to advertise.
We see absolutely no sense in Health Minister Datuk Seri Liow Tiong Lai’s statement on Sept 24 that the liberalisation of the guidelines under the Medicines (Advertisement and Sale) Act 1956 had been done “because medical tourism was a growing sector”.

All this because the government has targeted to increase the number of “medical tourists” by 20 per cent from last year’s figure of 336,000?  And why didn’t the government engage with civil society before approving the revised Advertising Guidelines for Healthcare Facilities and Services way back in July?

Convince us, please. Can we ever believe that members of the medical profession would be “cautious and professional” when advertising their services following the government’s decision to liberalise the provisions under the law?

We have raised this question several times before, and we must reiterate because neither the authorities nor the medical profession have responded truthfully: With patient load and services at private healthcare facilities increasing due to the aggressive promotion of services, charges for treatment will go up.

This means that the private sector will also have increased needs for medical staff and will move to attract those from government hospitals – which are in no position to match the remunerations offered.

Remember that for many years, despite the Health Ministry’s pledge to ensure efficient enforcement to ensure that all parties “keep within the prescribed ethical guidelines for advertising” there still were numerous occasions of advertisers flouting the law. And this was before this new development!

Today, in Europe and the United States, it is no longer the “medical profession”. It is the “medical industry”, a mafia involving private hospitals, pharmaceutical drugs and medical equipment manufacturers that are taking the lead, influencing the authorities and freely advertising on the print and electronic media, even in the Yellow Pages!

In the United States, the Advanced Medical Technology Association (AMTA), which represents medical device makers, released a new set of guidelines that its members have voluntarily taken up to make advertising more comprehensible to the public.

Over and above the regulations enforced by the US Food and Drug Administration (FDA), which is highly influenced by the American pharmaceutical industry, AMTA is praying that “endorsements by celebrities are acceptable as long as the ads are truthful and clearly state when actors are being used”. Thankfully, it added, the regulations are “voluntary and not enforceable by the FDA”.

Just take advertising directed to consumers on television or over the Internet on what well-equipped hospitals in the US can offer: It was worth an estimated US$193 million in 2007, according to a consulting firm, TNS Media Intelligence.

Also, consider what Philip Parker said in the Journal of Marketing Research way back in 1995: Most forms of advertising rely on “information asymmetry”, the idea that the party doing the marketing knows more about the product and how to sell it than the consumer.

Information asymmetries result in higher profits for advertisers. They know more, and the consumer, less. When the product is chewing gum, the imbalance is usually no big deal. But with something as crucial as healthcare – where the opportunities for information asymmetries happen to be much greater – all sorts of problems crop up!

Advertising empowers only the medical profession and the drug companies. Once patients get fixated on trying a certain medicine, chances are they’ll either pressure their doctor for a prescription or find another doctor who will supply it.

Medical advertising will only hit people when they’re ill and most vulnerable to the lure of a quick fix.

People will always buy from pharmacies, whether they want vitamins, tonics, remedies to help or cure indigestion, and even painkillers. All these are freely advertised.

And they need not queue up to see the doctor, and pay more for the doctor’s fees. So, please tell us, will advertising by the medical profession help?  Or cost the common man more, since the advertising cost will be worked into the fee payable by the patient?

There are many other unethical practices that are bound to increase as medical personnel pay more attention to the profit-making potential of healthcare.

Healthcare must not be treated as a business.

CAP wishes to reiterate our call to the Ministry of Health: Halt the practice of encouraging medical tourism and address the shortfalls that are ailing our present healthcare system.  The needs of Malaysians must be priority.

Letter to the Editor, 5 October 2010