Doctors may no longer be banned from advertising, but if you want to promote your services you must observe certain rules, as Dr Gerard Panting explains
The General Medical Council no longer refers to advertising, preferring the phrase ïproviding information about your servicesÍ – a subheading of the
section on probity in Good Medical Practice.1
The GMC is now in favour of doctors providing accurate information about services to patients as long as both their own guidance, and that of the Advertising Standards Authority (ASA), is heeded.
Moreover, since the GPsÍ terms of service were amended in 1992, it has been a requirement for NHS principals to publish a practice leaflet setting out certain details about practice arrangements.
All this may seem a far cry from the days when advertising was deemed to amount to serious professional misconduct. However, before contacting the nearest PR agency to boost your practice profile and earnings potential it is important to be clear about exactly what the GMC might mean by advertising or providing information about your services.
What sort of information can GPs publish?
The GMCÍs first piece of advice is:
ñIf you publish information about the services you provide, the information must be factual and verifiable. It must be published in a way that conforms with the law and the guidance issued by the Advertising Standards Authority.î
Following the Codes
The ASAÍs British Codes of Advertising and Sales Promotion require that all advertisements should be legal, decent, honest and truthful and prepared with a sense of responsibility to customers and society. All advertisements should respect the principles of fair competition that are generally accepted in business, and no advertisement should bring advertising into disrepute.
Responsibility for observing the Codes falls on advertisers, but others involved in preparing and publishing advertisements (which might easily include doctors in relation to private clinics) also accept an obligation to abide by the Codes.
In addition to the general principles, specific rules apply to health and beauty products and therapies, and also to slimming products. Any claims made about health related products should be evidence based. Advertisements should not suggest that any product is safe or effective merely because it is natural, and claims made for the treatment of ïminor addictions and bad habitsÍ should make clear the vital role of willpower.2
When it comes to slimming, the Codes state that advertisements for any slimming regimen or establishment should not be directed at, or contain anything that would appeal to, people under the age of 18 years. It also defines obesity as a condition in which the individualÍs weight is more than 20% above the ideal range for their height or whose body mass index is more than 30. The Codes also state that obesity requires medical intervention, and treatments for it should not be advertised to the public unless they are used under qualified supervision – although the term ïqualified supervisionÍ is not defined.
The Codes go on to state that advertisements should give prominence to the role of diet and should not give the impression that dieters cannot fail or can eat as much as they want and still lose weight.
The Codes state that homoeopathic medicinal products must be registered in the UK and any product information given in the advertisement should be confined to what appears on the label. Advertisements should also contain a warning to consult a doctor if symptoms persist.
The Medicines Act
The advertising of medicines is governed by the 1968 Medicines Act and subsequent regulations. In practice, this means obtaining authority from the Medicines Control Agency before any advertising takes place. In any event, prescription only medicines cannot be advertised directly to the public.
What sort of claims can GPs make about their services?
The next piece of advice from the GMC is as follows:
ñThe information you publish must not make unjustifiable claims about the quality of your services. It must not, in any way, offer guarantees of cures nor exploit patientsÍ vulnerability or lack of medical knowledge.î
There have been a number of instances of doctors promoting completely speculative treatments for a wide range of ailments, from chronic fatigue to HIV infection, where either no remedy is available or none has worked. Quite understandably, the GMC takes a tough line on doctors who exploit patients for profit by peddling concoctions that have no discernible benefit.
Doctors are required by the GMC to be open in any financial arrangements with patients, particularly in relation to private practice. Doctors are required to provide information about fees and charges before obtaining a patientÍs consent to treatment wherever possible and to ensure that patients are not put under pressure to accept private treatment.
How can GPs attract patients to use their services?
The last piece of advice from the GMC is:
ñInformation you publish about your services must not put pressure on people to use a service, for example by arousing ill-founded fear for their future health. Similarly, you must not advertise your services by visiting or telephoning prospective patients either in person or through a deputy.î
It is, therefore, perfectly acceptable to distribute practice leaflets or other information about the services you provide in the area in which you want to provide them. However, knocking on peopleÍs doors and canvassing is prohibited, as is using any other technique that might be construed as pressurising potential patients.
The GMCÍs guidance no longer draws a distinction between primary and secondary care. Originally, only doctors providing primary care services were permitted to advertise directly to the public. Specialists could only provide information to other healthcare practitioners. This led to a debate on what did or did not amount to primary care. Now that distinction has been abandoned, it is permissible for doctors to advertise specialist services provided in general practice direct to the public.
Criticising the opposition
Another change in GMC advice is the removal of any reference to claims of superiority. However, this should not be taken as carte blanche to rubbish the opposition. The Codes of advertising expressly state that advertisers should not unfairly attack or discredit other businesses or their products.
Good Medical Practice, under the heading ïTreating patients fairlyÍ, also states:
ñYou must not undermine patientsÍ trust in the care or treatment they receive, or in the judgment of those treating them, by making malicious or unfounded criticisms of colleagues.î
Direct comparisons should be avoided – they may be difficult to justify and will only antagonise practitioners who perceive themselves as being criticised and who may go on to complain to the GMC, the Advertising Standards Authority or both.
What can GPs do to provide information about services?
The prudent and, admittedly, conservative approach to providing information about the services you offer is simply to set out the key facts about the practice including the names and qualifications of the doctors and other healthcare professionals.
It could perhaps include a few biographical details and any special interests that they may have, together with contact details, opening times and any other factual information patients and potential patients may need to know.
There is no restriction on the media that may be used. It is perfectly acceptable for practices to have their own websites or to advertise in newspapers or magazines as well as distributing practice leaflets through the practice itself, public libraries or directly to peopleÍs homes.
- General Medical Council: Good Medical Practice. London: GMC, May 2001.
- The Advertising Standards Authority. The British Codes of Advertising and Sales Promotion. October 1999 with addendum added 3 April 2000.