Restriction lifted, province's doctors can advertise.

Restriction lifted, province's doctors can advertise

Historically, advertising has been taboo for Ontario doctors. However, that is in the process of changing.

Initiatives by doctors themselves have shown that the advertising is desired to varying degrees by the public, while the court has ruled that the former restriction on advertising was unconstitutional.

PROFESSIONALISM

Linda Franklin, director of communications with the Ontario College of Physicians and Surgeons, explained that the intent of the restriction was to preserve the professionalism of the medical profession.

"It was considered sort of unseemly for doctors to advertise," Franklin said in a telephone interview from Toronto.

There were also concerns that irresponsible advertising would bring the profession into disrepute.

Current regulations only permit limited advertising if a doctor opens a new practice or relocates. The information a doctor can place in the Yellow Pages is also regulated.

There are even controls on the circulation of business cards.

However, Franklin said, "Times and society have changed a lot."

She believes advertising is now needed and will be a real benefit to the public, allowing it to learn of such things as extended office hours.

"We at the college get about 100 calls per week from people looking for family doctors in towns they have moved into," she noted.

The college proposed changes to the Ministry of Health three years ago. However, at that time most doctors still did not want television advertising to be permitted.

"They were concerned they (television ads) would be in bad taste," Franklin said.

That concern arose from advertising in the United States, which she described as "bordering on the edge of bad taste."

However, Franklin does not expect such problems in Canada, noting that the college will monitor advertising and that Canadians tend to be more conservative than Americans.

Since the easing of restrictions in Ontario, she has learned of one TV commercial involving a doctor at a laser surgery clinic in Toronto.

COURT RULING

The lifting of the advertising restriction on doctors was given a boost by a court case involving two dentists who advertised their service, raising the ire of the Royal College of Dental Surgeons.

The dentists argued that the restriction infringed on their right to freedom of expression. The case went all the way to the Supreme Court of Canada, and the dentists won this past June.

While awaiting the court decision, the Ministry of Health did not change the advertising rules for any health-care professions.

Regulations for doctors are very similar to those for dentists, and lawyers have told the College of Physicians and Surgeons that its rules are unconstitutional.

However, the college has also been informed by the ministry that changes to the regulations may require time and consultation.

Therefore, the college has decided to live by the proposals it submitted to the ministry.

There are four general principles which form the basis of the college's proposed policy. The principles state that:

- members can advertise in any medium available to all doctors

- the information advertised must be true and verifiable

- the advertisements cannot be used to take advantage of patients (i.e. no direct solicitation)

- doctors cannot endorse products or provide testimonials

Franklin said most doctors are leery of endorsements.

While noting that some endorsement-style commercials could be in good taste, such as well-known American commercials for diapers, she said it would not be appropriate for a doctor to promote a jacuzzi, for instance.

That could make doctors look like "hucksters," she commented.

However, she believes that the no endorsement guideline could eventually be challenged in court.

While Franklin admitted that no one knows how doctors' advertising will evolve, she believes it will follow the example of lawyers. Since their restrictions were eased a few years ago, lawyers have not advertised to a great degree and, when they do advertise, it is usually in consumer magazines.

Thunder Bay's Dr. George Morrison, vice-president of the College of Physicians and Surgeons and a member of the college's council, believes the new principles are an improvement

"They are also an acceptance of reality," he said, pointing to the Supreme Court decision.

Morrison believes doctors should not try to attract new business, but should have the ability to acquaint the public with their practices.

Doctors are generally a conservative group, be noted, adding that he does not expect flamboyant advertising such as billboards or TV commercials.

In fact, Morrison has encountered very little interest in advertising from doctors. "Very few people have commented to me about it."

DISAGREEMENT

John Krauser, associated director of health policy with the Ontario Medical Association (OMA), said the organization has been considering renewed advertising regulations since 1983.

"Fundamentally, we agree that the current regulations are too restrictive," Krauser said by telephone from Toronto.

However, he added, "We're not in agreement with the college's proposals."

Krauser said there is some evidence that advertising is not the most effective way for doctors to find new patients.

Rather, the OMA believes word of mouth and referrals should be promoted, he said. "The emphasis is wrong just to focus on advertising."

Krauser also noted that the OMA believes advertising should be limited to newspapers and should include only the following information about doctors: name, sex, location of practice, hours of operation, languages spoken, telephone number, certified specialty, any restriction on practice, hospital affiliation, and year and school of graduation.

"It would be factual, not persuasive information, but useful."

Anyone contacting a doctor as a result of advertising could then receive more complete information.

"We're in favor of controlled liberalization," Krauser said.

The OMA has made its views known to the Ministry of Health.

In particular, Krauser said the OMA would not like to see TV advertising, in order to preserve the image of the profession and to protect vulnerable patients.

A ban on TV advertising would also prevent the bypassing of family doctors, he said.

MIXED FEELINGS

Dr. Wendy Graham of North Bay said by physicians have mixed feelings about advertising.

Graham is a member of a OMA committee which has looked at a wide range of controversial issues, including advertising.

"It is something I feel very strongly should remain appropriate, tasteful and not in any way misleading," she said, adding that false advertising should be punished.

However, she stressed that no such problem has ever occurred in Canada, noting that, as a professional body, doctors are quite responsible about advertising.

However, she believes some American doctors have not been as conscientious.

For example, she noted that an ad containing a 1-800 telephone number was published in North Bay advertising a cure for bedwetting. Anyone calling the number was asked for nearly $1,000 up front before even receiving information.

"I think the public has to be very sensible and wary about advertising," Graham said.

Nevertheless, she believes that, in the spirit of free enterprise, the public has the right to see what is available.

"It's surprising what the public wants to know," said Graham, noting that office location and parking availability are among the main things.

She doubts if advertising by doctors will become commonplace in Northern Ontario, explaining that it will be determined by supply and demand. North Bay, for instance, has shortage of doctors, meaning there is no need for them to advertise to attract patients, she said. On the other hand, Graham anticipates that advertising will become more prevalent in the more competitive Toronto area.