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How to hang out the shingle, ethically

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Doctors should be up-front and accountable about any money or other material benefit they get for promoting products and services, and must always put the interest of their patients first, the AMA has said.

Releasing revised guidelines on how to ethically advertise and endorse products and services, AMA President Associate Professor Brian Owler said the overriding duty of doctors was to act in the best interests of their patients, and to do this they must “maintain their professional autonomy, clinical independence and integrity”.

In particular, A/Professor Owler said, doctors must not allow relationships with industry to compromise, or be seen to compromise, their professional judgement, their ability to serve their patient’s best interests or damage the community’s trust in the integrity of the medical profession.

Just how high that standard is was revealed in a poll of 1206 adults commissioned by Reader’s Digest survey that found doctors were among the most trusted professionals, just behind paramedics, firefighters, rescue volunteers and nurses.

Significantly, doctors and medical researchers headed the list of the nation’s most trusted people. Neurosurgeon Dr Charlie Teo received top ranking as a person of integrity, followed by burns specialist Professor Fiona Wood and immunologist Professor Ian Frazer.

In its Position Statement on Advertising and Public Endorsement, the AMA said doctors could advertise their services, but only in a way that did not compromise patient care or the standing of colleagues or the profession.

“The chief purpose of advertising …medical services is to present information reasonably needed by patients, doctors and other health care professionals,” the Position Statement said. “For example, factual information about professional qualifications, services and practice arrangements.”

It said any advertising should be truthful, factual, should not attempt to make patients apprehensive or fearful about their health, should not exploit a lack of medical knowledge, should not disparage other medical services or products, and should not make claims of superiority.

In particular, the guidelines make clear doctors should not solicit testimonials, and the offer of gifts, discounts or prizes in advertising was “not appropriate”.

The AMA said it was not unethical for a doctor to receive money or other material benefit for promoting a product or service, but only as long as they were transparent and accountable about the arrangement.

This could be a particularly sensitive issue in the care of individual patients, and the AMA advised that doctors should only recommend products and services based on the needs of the patient, rather than any commercial interest.

Where the doctor did have a financial interest, the Position Statement said, the doctor had an obligation to disclose it to their patient at the time.

 The AMA urged doctors to be careful in promoting products and services, and to avoid endorsing medicines and medical devices directly to the public.

It warned that the public’s high regard for the medical profession meant that “commercial entities” would seek out doctors to promote their products and services.

It said doctors should not have any public association with products that clearly harmed health, and should be cautious about promoting health services such as pharmacies, nursing homes or private clinics, as well as products and services not directly related to health care.

The Position Statement can be viewed at: position-statement/advertising-and-public-endorsement-2004-editorially-revised-2006-revised-2014

Adrian Rollins