Medical advertising to be changed?

Gary Culliton reports on the upcoming changes to the Medical Council’s Code of Ethics on advertising and how it will affect doctors
The Medical Council’s Code of Ethics concerning advertisements is to be changed before the end of April, to tackle the issue of advertising by cosmetic surgery clinics. The Council can regulate doctors but there is no regulation of the sites where they work.

“We cannot stop these clinics advertising. If an individual doctor advertises, we can call the doctor to account,” said Dr Colm Quigley, President of the Medical Council.
“Some doctors do advertise and sometimes excessively so. But there is no regulation of these clinics and the Council has brought this to the attention of the Minister.”
“Many doctors feel they are disadvantaged in relation to clinics and private hospitals, who are able to advertise services to the public,” said the IMO GP Leader, Dr Martin Daly.
“A significant number of GPs also feel that if advertising is not regulated in some way, this may lead to a lowering of professional standards. The experience of the legal profession is one many doctors would hope we would not follow. While a loosening of regulations around the ability to advertise their services would be welcomed by many doctors, it’s to be hoped that there would be sufficient regulation to avoid any lowering of professional standards.”
The number of Irish people opting for nose jobs, tummy tucks, facelifts and breast enlargements has never been higher, and most clinics in Ireland are reporting a significant increase in customers year on year. The industry is worth an estimated €20 million a year.
Either the Medical Council or Health Information and Quality Authority (HIQA) should have a role in the regulation of advertising of services in private hospitals and clinics, most especially regarding cosmetic medicine, Dr Daly said. “There’s a great concern that aggressive advertising tends to blind the public to the potential pitfalls of particular procedures,” he added.
h4. Vulnerable people
The Medical Council opines that vulnerable people in society – whom doctors see on a regular basis – are in need of protection from unscrupulous advertising. The Competition Authority (CA) takes a different view and sees a role for advertising in an efficient market. “I think the Competition Authority has more power than the Government in the regulation of services in this country. It’s obvious that the CA sees itself as independent of Government and answerable only to Europe. It’s not clear if it would be helpful to either the Medical Council or HIQA in regulating advertising in the medical area,” said Dr Daly.
Currently doctors can only advertise in certain ways. However corporate entities have greater freedom. Clinics are not restricted from advertising, as long as the doctor is not named. “If a clinic advertises a service, we’ve no role to regulate that,” Dr Quigley said.
h4. Patients’ best interests
“A sensible approach would involve advertising based on evidence, so that vulnerable patients aren’t taken advantage of. We’re not trying to be protectionist, we’re trying to ensure that patients’ best interests are served,” said Dr Quigley. “Patients are entitled to information but we’re concerned that patients might be unwittingly misled by some of the claims made.”
The matter of how corporate entities are to be regulated must be addressed at Government level, Dr Daly said. He advocates a combined approach involving a number of bodies — the Medical Council, HIQA and possibly the Competition Authority.
“It would appear the CA favours deregulating the ability of doctors, hospitals and clinics to advertise. In the area of medicine, where many decisions concerning whether to treat or not to treat require informed patient consent and adequate follow-up care, it may be we need a different view, as compared with other services provided in the market,” Dr Daly said.
“Unfortunately, the view in Government is that the CA acts independently without Government direction. This may make the work of the Medical Council and HIQA very difficult.”
There is a debate going on currently in the Medical Council. The Ethics Committee is due to make a recommendation to the full Council. The Council has had representations from plastic surgeons who have seen poor outcomes in Irish clinics for some patients.
h4. Forces at work
“There are forces at work to increase the amount of advertising. The Medical Council is concerned about the matter. Where people are advocating invasive surgery for cosmetic reasons, that has to be carefully undertaken,” Dr Quigley said.
“There are complications associated with it which cannot be ignored. It’s important that patients are fully informed in advance and that their aftercare is certainly adequate.”
The Ethics Committee, which is actively discussing the matter at present, wants to get the Code changed before the current Council goes out of office. The Medical Council is starting to run into issues with the CA and others.
The Medical Council has had a number of submissions on a revised Code of Ethics, including from the CA. The CA’s view is closer to the ‘let the buyer beware’ principle. The Council is reviewing its ethical code and is currently concentrating on the issue of advertising.
When its Ethical Committee, chaired by Dr Deirdre Madden, has formed an opinion within the next few weeks, this will be considered by the full Medical Council.