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June 23, 2014
Rebecca Bechhold, MD
Rebecca Bechhold, MD

Is there any truth in advertising? A recent study found that cancer center ads only emphasize positive outcomes, but other than direct-to-consumer marketing of pharmaceuticals that list all possible side effects, are you aware of any ads that state less than optimal outcomes?

No, not the 2014 ASCO presentations-I am referring to the study that found that cancer center advertising emphasizes positive outcomes and says nothing about side effects or costs. Yawn.

Other than direct-to-consumer marketing of pharmaceuticals that require that low, fast-talking voice at the end to read all possible side effects, are you aware of any ads that state less than optimal outcomes? The purpose of the cancer center ad is to drive business to the cancer center. You bring them in by showing the intended audience that you treat healthy-looking people who happen to have cancer, implying that your treatments are all new and cutting-edge, and suggesting that your doctors spend a lot of time with each patient often while standing in wide, windowed hallways. They are also all nice-looking and well groomed. But for the same reason that there is a successful skin cream called Hope in a Bottle, you should remember that when you are looking for a solution, you focus on what you hope and wish to be your desired outcome. Is there any truth in advertising? Women’s faces are Photoshopped to be devoid of any pores, men all have six-pack abs, sugar cereals are whole grain goodness. It’s all not quite honest and certainly not real. But if you are vulnerable, you buy into the promise, the image.

I have tried for years to get my group to include hospice information in the patient packet. No, too negative and scary. Really? If you are told you have cancer, what is the first thing people think of? “Am I going to die from this?” Many times the answer is yes. Not right now, but eventually, probably. I did finally get a link to our preferred hospice on our website. But it is not the first thing you discuss and certainly is not going to be the highlight of any ad campaign.

Some cancer patients are susceptible to any suggestion that one institution always offers a cure. There is a well-recognized for-profit cancer center in America that advertises incessantly, giving the impression that they have far superior results to any other cancer group. If you cherry-pick your patients, yes, you will have better statistics. If they are going to offer stats, which few centers do, shouldn’t they have to reveal how they came up with those survival rates?

Honestly, when you start surfing the Web to purchase a product or service, how do you choose? You comparison-shop, check prices and reviews, ask friends for recommendations. Why would it be different for a medical service? They need to discriminate about all healthcare ads-orthopedic services, weight loss, hormone replacement, new drugs-not just cancer care.

Perhaps the most honest ad for a cancer center would have a dollar sign on top of each patient. ASCO is now over and one of the strongest campaigns there was that oncologists are responsible to bring down the cost of cancer care. News flash-the way most oncologists create income is by giving chemotherapy. One doctor I chatted with said that his practice had been purchased by a hospital system in his town, and he was crowing about how much they were paying him. His statement to me was, “Each oncologist they hire is worth $1 million in income a year from chemotherapy alone.” With 340b pricing, it probably is, but I cannot personally guarantee the validity of that statement. I suspect that the hospital that owns him advertises on a regular basis.

Like it or not, healthcare is a business. And the way it is currently arranged, oncologists are paid more when they give more chemotherapy. (Before you go ballistic, I am paid under the same arrangement and am not claiming immunity.) The business manager for a practice-big or small-is charged with growing the revenue, and you do that by attracting patients. Just as when a layperson asks you for your opinion about a friend or family member, and you reply, “I can’t possibly say what I would do for this particular case, but we have a lot of clinical trials available and, in general, early-stage breast cancer does very well,” cancer centers can only project the best possible face to the public. Once they have the patient and records, then they are responsible to be completely honest about treatments, outcomes, and side effects. But until you get them in the door, as Don Draper would say, “you have to tell them a story.”