On advertising

Your comments have been a little tame and complimentary lately, so it is time to throw some meat to the lions and stir up some discussion. This is about hospital advertising.

I opened up my latest version of Newton Magazine, a very nice local monthly publication edited by Jonathan Brickman that is targeted to one particular suburb of Boston. The ad on the inside cover is about an orthopaedic service offered by Newton Wellesley Hospital in collaboration with Massachusetts General Hospital. Page four has a full-page ad about diabetes from the Joslin Diabetes center. Page seven has a full page ad about heartburn and other digestive disease treatments at BIDMC. Then, of course, there are the smaller ads sprinkled through the magazine from practitioners in cosmetic dentistry, ophthalmic services, varicose veins, plastic surgery, concierge primary care, in-vitro fertilization, acupuncture, psychology, home care, assisted living, and cord blood banking. But for this post, let me focus on the hospital ads.

Putting on my consumer hat for a moment, I briefly had the same reaction that I have when I watch those drugs ads on television: Do these ads work? Well, we certainly know that the drugs ads work in creating demand for those products -- often to the dismay of doctors who do not really want to prescribe them. That has been documented.

To answer the question for hospitals -- "Do these ads work?" -- you need to consider their purpose. One purpose might be to encourage consumers to seek elective treatment for a condition about which they might not have considered treatment (e.g., that arthroscopic surgery for a knee injury) and another is to try to have them consider your particular hospital for the treatment they have chosen. Effectiveness for the first is hard to measure. Although insurance companies will tell you that many more people are seeking those elective treatments than ever before, it is hard to know if that is tied to marketing. Effectiveness for the second is equally hard to measure, although sometimes a hospital will be able to track a patient's initial phone call to a given ad.

Another purpose is to respond from pressure from your doctors and show them that you support their programs. Before I took this job, I talked with the head of a major Boston hospital who gave that as the primary reason for ads. "There is no evidence that ads work in creating business," he said, "but we need to keep our doctors happy." I have certainly felt that pressure in my place, and so I understand the desire to send a signal to your doctors -- who, after all, are essentially free agents who can easily change hospital affiliation -- that you support their practices.

Another purpose might be to educate the public about certain diseases and treatments. I think academic medical centers like to rationalize that they are offering this general benefit to the public in their ads, but, really, who would consider these one-page blurbs an effective means for such education?

I think the ads are posted mainly as a component of creating a broader brand identity. In this regard, hospital ads are remarkably similar to many other corporate ads. But unlike other industries that use it to drive sales, brand identity in the medical field is probably minimally important in generating and maintaining a sufficient level of clinical business. Perhaps more important, it helps create a mindset that the hospital has standing and stature and permanence in the community. This is important in attracting employees, enhancing physician recruitment and affiliations with other hospitals and physician practices, and generating interest from lay members of the community to serve on the hospital's governing bodies and to offer philanthropic support. These three purposes are actually fundamental to commercial viability in the health care world, especially for academic medical centers.

I would love to receive comments from other hospital administrators and marketing firms on what I have just said. And, of course, from the rest of you, too, who are now drooling at the prospect of offering a heartfelt opinion.