Business Ethics in Healthcare: Beyond Compliance

Thirteen: Responsible Advertising

Advertising has long been recognized as a major tool in efforts to achieve business success. It has long been understood, at the same time, to be an ethically risky business tool. Education in the essentials of business ethics has always included consideration of the ways in which advertising can take unfair advantage of potential consumers or cause other harm. In its initial emphasis on organizational ethics, JCAHO has also recognized marketing and advertising as functions that require clear ethical standards. Much of the attention given to the ethics of advertising has been focused on the question of whether particular advertising is deceptive or misleading. This is obviously a legitimate and important concern, but as the above quote suggests, there are a number of other considerations that need to be taken into account in the process of developing responsible advertising. This is true of advertising generally; it may be even more true of healthcare advertising. Before discussing speci¤c ethical issues and standards in healthcare advertising , it may be useful to re®ect on the need for high ethical standards in marketing and advertising in healthcare. Marketing Healthcare Services: The Need for High Ethical Standards Some marketing methods involve, even if unintentionally, the adoption of a model of business that is not suitable for healthcare. Healthcare marketing needs to be compatible with the nature and mission of the healthcare organization . In an article recommending the adoption of a “business” model of managThirteen Responsible Advertising At its best, advertising can provide information to help consumers make informed choices. Conversely, it can in®ate expectations , create demand, manipulate desire, transform wants into perceived needs, and increase utilization and cost of health-care services.1 ing hospitals in order to succeed in an era of competition, Tasker Robinette made a distinction between being a “customer satis¤er” and being a “care provider”: Most of us view the traditionally organized not-for-pro¤t hospital as charitable and humanistic institution established for patient care, community service, scienti¤c research, and training and educational programs. . . . Hospitals must see themselves as customer satis¤ers. Once we’ve made that shift, rational management techniques can work. At ¤rst glance, the difference between customer satis¤er and care provider may seem insigni¤cant, but it is a fundamental difference .2 Robinette is correct, I think, in recognizing that there is a major difference between understanding the healthcare organization as customer satis¤er and understanding the organization as care provider (even though there are many ways in which care providers need to satisfy their customers). In the most radical sense of being a customer satis¤er, a business recognizes that the customer is boss, the customer is always right, the customer should have whatever he or she wants (and is willing and able to pay for). A business, as a good customer satis¤er, essentially gives customers what they want. A care provider business, on the other hand, recognizes that providing good care does not always mean satisfying the customer; it certainly does not mean always giving customers what they want. Success as a care provider is determined largely by the professional quality of the care provided, not by what the customer wants (whether the “customer” is the one who is cared for, the one who pays for the care, or the one who refers or admits someone for care). High-quality care does require that customers are satis¤ed in regard to the nature of the professional and personal interactions they encounter. In this sense, customer satisfaction is essential to good healthcare. This is very different , however, from giving customers the precise type of treatment or testing they might want. Being a good care provider and adhering to professional standards of quality means that a customer will de¤nitely not get what she or he wants at times and will not, in that sense, be satis¤ed. This discussion of Robinette’s distinction is not intended to play down the importance of giving “customers” of healthcare organizations the respect and deference they deserve. It is not intended to suggest that everyone who talks about the importance of satisfying customers is really seeing no difference between providing professional care and selling clothes. Rather, it is meant to remind healthcare managers that the “customer is queen” model of doing business is more suited to industries that provide goods and services that are not professional in nature. The marketing of healthcare services needs to be done in a manner that does not...