how much personal-details-scrubbed info about practice can doctor disclose in ads?

Factual Questions
1

suppose a new firm enters a crowded marketplace - a certain Dr. John Doe MD has just put up his shingle in a new city that he moved to. So, now he probably wants to convince a whole bunch of locals to start buying his services instead of buying services of his competitors or just doing without. Where I live, this task seems to call for an ad showing the guy with a big smile and an impressive list of degrees and specialties, printed on cheap paper in a yellow pages type tabloid magazine. Sometimes they also use billboards.

Now, suppose Dr. Doe wanted to be more innovative about how he goes about advertising. Could he let’s say create a website that would document the various medical cases he had to deal with in impersonal medicalese jargon (48 year old female had trouble to walk two blocks, I prescribed so-and-so, then two months later switched to cheaper generic, and now she is running marathons; overall she paid this much in cash and her insurance paid that much) as a way to give prospective patients an idea what they are getting into, what his philosophy in treating people is and so on?

Would that get Dr. Doe lose his license? What sort of info an MD is and is not allowed to openly disclose / advertise about his practice?

2

HIPAA prohibits the release of information which identifies the patient, including the following:

In the specific scenario you suggest, you might have to worry about that last clause. 48 year olds who go from having difficulty walking to running marathons are probably unusual enough that the patient’s acquaintances who read your advertisement will know who you are talking about. Therefore, doctors who publicly discuss patients they’ve treated, such as in a blog, will usually change enough details to render the patient unrecognizable even to those who know them.

As for whether the doctor would lose their license, HIPAA provides for civil and criminal penalties for violations. Effects on licensure is probably something which would vary from state to state, AFAIK.

3

Shmendrik, what you say seems to boil down to “yes, the doctor can indeed publish all this stuff”. After all, the actual elderly ladies don’t end up running marathons, not even courtesy of the wonderful Dr. Doe :-). So the typical medical case of a typical MD will be as anonymous as it gets, like the stuff they write about in medical journals.

Well, so why don’t the better doctors, or the more narcissistic ones who may consider themselves so, start publishing these medical and financial histories as I suggested? Why not show off accomplishment and stand out of the crowd of competitors who prefer to keep everything but the photo op smile under wraps?

4

The AMA and local state medical boards frown on that kind of thing. I couldn’t find a cite, but I think it was the mid 90’s when a proctologist in NYC who advertised under the name ‘Dr. Tush’ (maybe his real name) got into some trouble for his ads plastered on buses and subways. The one that set everybody off was a television commercial featuring a minstrel band.

You don’t sound like your suggesting anything that outrageous, but few doctors can work independently of other doctors and medical institutions. So there’s a certain level of peer pressure involved in the limiting.

OTOH, look at some of the ads for plastic surgeons, stomach stapling, and other vanity practises. They go pretty far sometimes.

5

I have no idea whether doctors have the equivalent, but the ethical rules on lawyers forbid you from listing your courtroom win statistics, for example. You can get in trouble with the bar association and maybe lose your license. The medical licensing agency holds similar power and may have similar rules, at least in some states.

6

ENugent, how do the laywer advertisement restrictions handle 3rd parties obtaining and distributing equivalent info? In other words, instead of John Doe Esq. publishing his win records let’s imagine the LegallyPaparazzi Corp collecting the data on all attorneys in the region and then making it available to customers for a fee or for some other reason? How would ABA respond, would they accuse all the affected lawyers of being secretly in cahoots with LegallyPaparazzi regardless of the truth or falsity of such a supposition?

Or is there a legal (heh) mechanism to stop such jerkish activities? E.g. can LegallyPaparazzi claim that Doe’s win record is available from public records and so they have a legal right to keep on publishing it regardless of whatever cease-and-desist letters he and his ABA oversight may be sending them?

7

I think that that would be legit, as long as no lawyer was using LegallyPaparazzi’s information in advertising or providing them with client-confidential information.

8

What purpose does this serve? This is exactly the sort of information that would be valuable to me in hiring a lawyer. How do I know I’m not getting a lawyer who has lost even the most simple cases?

9

Lawyers will give you this information when you talk to them. They just can’t use it in their advertising. You can also look around online to get it.

The common thread is that doctors and lawyers can’t make anything that sounds like a guarantee in their advertising. Every patient is different; Dr. Doe’s miracle treatment may have helped the grandmother run a marathon, but that doesn’t mean that you’ll be able to do the same. The lawyer’s skill may have been able to keep most of his clients out of jail, but he may not be able to do the same for you. Neither is in a position to make a promise, so they’re not allowed to imply they can in their advertising.

10

Depends on your jurisdiction.

The UK has pretty draconian regulations relating to advertising by doctors.

From the GMC guidance aimed at Cosmetic surgeons:

*If you publish information, on paper or electronically, or broadcast information about services you provide, the information must be factual and verifiable.

It must be legal, factual and not misleading and incorporate a sense of responsibility to consumers and society.

Marketing materials must be drafted and designed to safeguard patients from unrealistic expectations.

Advertisements in journals, newspapers and magazines should not include photographs that suggest the outcome of surgery will be reflected in the photograph.

The information you publish must not make unjustifiable claims about the quality of your services nor compare your services with those your colleagues provide.

It must not in any way offer guarantees of cures, nor exploit patient’s
vulnerability or lack of medical knowledge.

Information you publish about your services must not put pressure on people to use a service, for example by arousing ill-founded fear for their future health.

Similarly you must not advertise your services by visiting or telephoning
prospective patients, either in person or through a deputy.

There must be published information for patients, which sets out the range of procedures carried out at the facility.

Advertisements must not offer discounts linked to a deadline date for booking appointments or surgery or other date-linked incentives.

Promotional events such as open evenings must not include financial incentives for potential patients to book a consultation appointment at the event. *

11

You don’t have to scrub the info if the patients allow you to use their stories. Many of the hospitals here in the Chicago area, for instance, have patients and/or their doctors talking about their tough case and how they worked together to save the patient’s life/baby/mobility/whatever. TV and radio ads, newspaper ads, webpages; all of these are used.