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Last Updated Wednesday July 26 2017 08:29 PM IST

Matters of the Heart | Advertising by doctors, and medical ethics

Dr Roy John Korula
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Matters of the Heart

The other day, I was going through one of the largest circulating periodicals in the country, when I came across an advertisement, which claimed that a medicine invented by an IAS officer, based on Vedic Literature, had anti-aging properties and cured many diseases from “liver cirrhosis to “renal failure.” It also declared that it “prevents the cause, and cures the incurable.”

The same day, I read another in one of the leading English magazines in the country. “Dendritic Cell Therapy for the treatment of Stage IV cancers”, “with a 30 percent long term remission, which is a conservative term for cure.” Really? 30 percent cure for all Stage 4 cancers? That, to put it mildly, is misleading and deceptive. The doctor’s name, photograph, contact numbers, etc., were all displayed in the advertisement.

Also read: Matters of the Heart | Should I disclose my error to a patient?

In general, advertisements should also be socially responsible, factual, truthful, appropriate and not misleading.

But for doctors to advertise themselves is unethical.

I quote below the Medical Council of India Code of Ethics regarding advertising, which is applicable to doctors in our country. These are classified under “Unethical practices” in their code of conduct, and is punishable by a fine, being debarred from practising medicine, and/or imprisonment.

Also check: Matters of the Heart | Beating heart surgery vs conventional coronary artery bypass grafting

A physician shall not make use of him / her (or his / her name) as subject of any form or manner of advertising or publicity through any mode. either alone or in conjunction with others which is of such a character as to invite attention to him or to his professional position, skill, qualification, achievements, attainments, specialities, appointments, associations, affiliations or honors and/or of such character as would ordinarily result in his self aggrandizement

Doctor

A physician shall not give to any person, whether for compensation or otherwise, any approval...for use in connection with his name, signature, or photograph in any form or manner of advertising through any mode nor shall he boast of cases, operations, cures or remedies or permit the publication of report thereof through any mode.”

Clearly, what is being done is “unethical”. Yet, we see it happening every day. These invalid promises of favorable outcomes, unfounded claims of cure, exaggeration of end results, and misinformation about competitive superiority are to be categorically condemned.

Also check: Matters of the Heart | Fee-splitting – the unethical side of medical practice today

Let’s face it. This is being done by hospitals (and doctors) to canvass for patients. Sadly, most of the major TV channels and major national newspapers are complicit in this sort of unprincipled, dishonorable (and often misleading) advertisements.

New procedures and modes of treatment are being advertised, without their safety profiles being fully known, without randomized trials to prove their efficacy, without their end-results being evidence based, and without their outcomes being replicated by peers – which is the ultimate proof of success of any treatment or analysis. Besides, these claims are often false and deceptive. If the media didn’t permit such unprofessional, unsubstantiated news reports, then no doctor or hospital would be able to use this cheap publicity to gain prominence and garner public attention in order to solicit patients.

Doctor

Often the advertisements say that this particular type of treatment is “the best” or “one-of-its-kind” or “the first in the country” (how do they know?). Or “no cure, no payment”, “guaranteed cure” etc. Like the advert for a toothpaste on TV, with a UK-based dentist claiming its superiority for reducing sensitivity of teeth. Have they done any comparative randomized trials on this?

Often the news item is designed to suggest that one favorable outcome translates into a positive result for everyone. Like this one in a national newspaper: the headline read “A team of homeopaths and scientists cure eight people of HIV in Hyderabad”. The inference clearly being that HIV can be cured by homeopathy. The article also said that the National AIDS Organization had called this outrageous claim fraudulent, and was planning legal action against them.

Doctor

The Medical Council of India in 2011 took the Indian Medical Association to court for violating medical ethics over their 2.25 crore contract with Pepsico to allow Tropicana fruit juice and Quaker oats to use the IMA logo on their products. The IMA agreed that they had made a mistake, but said that they had entered the MOU only for “nutritional awareness purposes,” and that the settlement amount for breaking the contract would be too costly. Sadly, the IMA has contracts endorsing products such as Dettol (an antiseptic), Lyzol (a sanitizer), Aquaguard (a water purifier), Pampers (napkins), Odomos (a mosquito repellent) etc. Instead of being a model for ethical practices in the country, the IMA has shown itself to be a body of unprincipled people, with clear conflict of interest in their dealings.

Then, regretfully, there are others, which are truly exceptional surgical successes, but the doctors have turned to publicity for promoting their expertise and competence. Like this one. “Portion of liver removed from live donor, and transplanted” at a Coimbatore City Hospital. This was done laparoscopically (which is truly commendable). However, the patient’s name, names of doctors involved in the transplant, their photographs, and the name of the hospital was prominently displayed. This is nothing else but to gain exposure and solicit patients for the doctor and the hospital by advertising the doctors skills, and the hospital’s facilities. And the newspaper is equally guilty of publishing such “cases, operations, cures or remedies,” which are specifically prohibited by the Medical Council of India. Instead, if the doctors wanted to make this known, they should have reported this case in a peer-reviewed journal.

So it is up to the print media, TV channels and the digital media. If they stop printing this in the press, or broadcasting this on the radio or television, then this whole business of unscrupulous, amoral advertising will come to an end.

People will do anything for monetary gain, including blatantly breaking the law.

Unfortunately, and sadly, some doctors think they are above the law.

Is anybody in the media at least listening?

(The author is a former head of the department of cardiothoracic surgery at Christian Medical College and Hospital, Vellore. He is currently the chief administrative of icer, and head of the cardiothoracic surgery department at Pushpagiri Heart Institute, Tiruvalla.)

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