Advertising in ophthalmology: truthful and ethical

Advertising in ophthalmology has gone through a series of changes since the 1970s, when rapid transformations in the industry were taking place.

Sanjay Goel, MD, president-elect of the Maryland Society of Eye Physicians and Surgeons, discussed how to advertise properly medical services that conform to the laws in his presentation "Advertising in Ophthalmology: The Good, Bad and the Ugly" at the American Academy of Ophthalmology's 20th Annual Current Concepts in Ophthalmology conference in Baltimore, MD.

A historical perspective on advertising in ophthalmology shows that as far back as 1847, medical ethics prevented physicians from advertising. In the 1970s, the Supreme Court weighed in on professional advertising, declaring it legal. The Federal Trade Commission (FTC) found that the ban on advertising prevented patients from obtaining information about quality, price, availability, and value of health care.

The Code of Ethics was structured to include principles (general standards), rules (specific minimum standards), and administrative procedures (investigation, enforcement, sanctions, and appeals). A draft code was submitted to the FTC and approved in 1983, going into effect in 1984. Today the code is a living document with ongoing revisions, advisory opinions, and rules.

Dr. Goel, Maryland medical director of Lasik PLUS Laser Vision Centers, said once physicians were allowed to advertise, "treatments became known as goods and services, patients became clients, physicians became providers, and colleagues became competitors."

The Academy later added Rule 13 for advertising. Rule 13 called for no false, deceptive, or misleading information; no deceptive omissions; no appeals to patients' anxiety; must not create unjustified expectations of results; must disclose risks; must not misrepresent credentials; and no unsubstantiated claims of superiority.

Rule 13 also addressed communications to the public, indicating they must be accurate and advertising must be truthful and ethical. Any comments about results and safety claims must be backed by proven scientific results and cannot be anecdotal, and it warned physicians never to mislead by commission or omission, never misinform, and never promote medical or economic deception.

Misleading phrases that can have ambiguous meanings should not be used in advertising, according to Dr. Goel. Some of these phrases include safe, easy, painless, bloodless, pioneer, leader, or world famous.

Violations can lead to a cease and desist order or fines of $11,000 per day, per ad. It can also lead to censure, suspended license, or filings in civil court.

Useful information to include in advertisements includes the type of practice, specialty board certification, office hours, and service descriptions.