Does advertising by hospitals and healthcare systems have any relationship to quality? This question was answered in a
Journal of the American Medical Association article last month. The unsettling conclusion stated:
The results of this cross-sectional study suggest that the amount hospitals spent on direct-to-consumer advertising was not associated with publicly reported measures of hospital quality; instead, hospital advertising spending was higher for financially stable hospitals with higher net incomes.
Healthcare has evolved dramatically over the past fifty years to include much more emphasis on financial well-being, in addition to the noble calling focused on caring for patients.
A precept, shared by a famous clinician at Columbia-Presbyterian Medical Center with two co-interns and me during the first very nervous days of medical internship in July 1973, was “Always care for the patient; and even if things don’t go as well as expected, the patient will know you have tried your best.”
Every conscientious, newly-minted physician is obsessed with the fear of inadvertently harming a patient. I still recall the early morning anxiety of that July as almost equivalent to “morning sickness” (and I’m male) while I walked past the portal of the Vagelos College of Physicians and Surgeons proclaiming, “
For the Most High Cometh Healing.”
Now, financial concerns seem to have taken ascendency in the industry as many non-traditional sources of care have become commonplace—chain drug stores, traditional big-box discount stores, telemedicine, etc. Of course, maintaining solvency is fundamental to the ability of continuing the mission of caring for people.
But almost half of the more affluent healthcare systems (2239 of 4569 or 49% included in the study) are using valuable resources on marketing—probably not part of their mission statements. Boasting via a marketing scheme, when objective differences do not confirm the facts, doesn’t help anyone. The mortality rate, readmission rate, patient satisfaction, and Center for Medicare and Medicaid star ratings were not meaningfully different between hospitals and healthcare systems that advertised and those that did not. The financially better-off hospitals spent money on advertising as noted in the above conclusion.
Differentiating the image of any large system by bringing well-being to entire populations would not only help people live longer, happier, and healthier lives but also make that medical institution the first choice when needed. Optimistically, people want to stay well and avoid being in a hospital. However, if hospitalization is needed, then people want a hospital with excellent metrics.
Would it not make more sense to take “excess profits” and plow them back into a prevention program? Changing focus from growing in-patient market share to improving prevention long-term will be not only necessary but also beneficial as healthcare reimbursement evolves from fee-for-service to
pay-for-value.
Everyone will benefit—patients and healthcare providers—as costs decrease. Now caring for entire communities has been proven effective for over 4 million people in 60+ communities and growing. Transferring dollars from traditional marketing to long-term benefits does objectively add years of life expectancy across the socio-economic spectrum.