Updated AMA Policy on Advertising and Public Endorsement

Dr Andrew Miller, Chair AMA Ethics and Medico Legal Committee

Doctors have a legitimate interest in advertising their medical services; however, inappropriate advertising practices have the very real potential to harm both individuals and the wider community.

In recently updating its policy on advertising and public endorsement by doctors, now referred to as the Position Statement on Advertising and Public Endorsement 2020, the AMA’s Ethics and Medico-Legal Committee (EMLC) concluded that the line between appropriate and inappropriate advertising is increasingly blurred. This can lead to confusion for doctors in how to meet their ethical, legal and professional obligations and potentially result in harm to patients.

The AMA’s updated policy will support members by referring to a range of legal obligations and professional standards set by entities such as the Australian Health Practitioner Regulation Agency (Ahpra), the Medical Board and the Therapeutic Goods Administration while providing additional ethical guidance to support doctors to advertise in the interests of patients and the wider community.

Advertising by doctors should be guided by ethical values including respect, honesty, integrity, transparency and accountability. They should facilitate - , not undermine - informed patient choice, relevant medical referral and the community’s trust and confidence in the medical profession.

Inappropriate advertising practices can be coercive and exploitative in nature (possibly unintentionally), leading some individuals to use products or services indiscriminately or unnecessarily, potentially resulting in physical, psychological and/or financial harm. Further, inappropriate advertising feeds the perception that doctors are greedy and self-interested, caring more about their own personal and financial interests than patients’ interests, damaging community trust and confidence in the integrity of the medical profession.

A good example of inappropriate advertising is outlined in section 7 of the position statement – pathologising human conditions and experiences. This refers to advertising practices that portray human conditions and experiences as pathological conditions requiring medical treatment in situations where this is not medically indicated. For example, advertising that promotes unrealistic body images, targeting common features of the human lifecycle such as wrinkles, skin laxity, breast ptosis or baldness that are not actually pathological in nature nor in need of medical treatment, exploits individuals’ vulnerabilities, contributes to poor mental health and encourages unnecessary medical consumerism.

While doctors should clearly not be involved in these inappropriate advertising practices, there are less obvious forms of advertising that can nonetheless prove ethically (and sometimes professionally and legally) problematic if not managed effectively. For example, social media increasingly lends itself to innovative and unique ways to advertise medical services to potential patients, colleagues and other third parties. The ‘real time’ nature of social media allows doctors to post up-to-date information such as changes to practice arrangements which can benefit patients by enabling them to make informed decisions about the appropriateness of the services.

The interactive nature of social media can also enable doctors to engage directly and publicly with patients and others on doctors’ own social media platforms. For example, by allowing individuals to post comments or questions on a doctor’s Facebook page, comments that appear (deliberately or inadvertently) to entice or persuade others to use the doctor’s service can be considered a form of advertising even if the doctor did not solicit the comments. Not only is this ethically problematic but Ahpra may consider such comments to be testimonials which are distinctly banned under section 133 of the National Law. Some confusion in this area has arisen in relation to enforcement, due to the obvious proliferation of advertising on some social media platforms that seems to infringe this regularly, but goes uncorrected.

As the opportunities to advertise in new, innovative and dynamic ways continue to grow, the AMA’s Position Statement on Advertising and Public Endorsement 2020 will assist members to not only meet their legal and professional obligations but to maintain a strong ethical focus to advertise in the interests of patients and the wider community.

The position statement outlines the ethical principles to guide doctors’ advertising practices, refers to relevant legal obligations and professional standards, and addresses advertising in a range of contexts including advertising of medical services; social media advertising; publicly endorsing products and services; participating in media reports, magazine articles and advertorials; and pathologising human conditions and experiences.

The Position Statement on Advertising and Public Endorsement 2020 can be found here.