This New York City subway ad recently caught my attention: “When researching hospitals, consider how much research they do.”
The ad for Mt. Sinai Health System advised riders that the research “we do today drives medicine we will do tomorrow,” and the hospital system was proud that it ranked among the top four medical schools in the country in research dollars per investigator.
I’m used to outlandish and questionable advertising, but this ad rose to a new level.
If I were looking for a hospital for a surgical procedure or were taken to a facility in critical condition as I was in 2017, the last thing I’d care about was that the hospital ranked highly for “research dollars per investigator” – whatever that means.
How does implying that the research a hospital conducts today, which will take years to benefit patients if it pans out, indicate the hospital is currently giving superior care?
Why is this information something I need to know before choosing a hospital? I can think of several other measures – like a hospital’s infection rates for bloodstream or surgical site infections or its readmission rates – that can indicate poor care and are far more useful. These metrics are sometimes available on state health department websites or on the Medicare Hospital Compare site.
This kind of hospital corporate advertising falls into the same bucket as ads that tout medical miracles for hard-to-cure patients that occurred in the hospital paying for the ads. Residents have probably seen those, too. For months New York Presbyterian promoted the story of a little girl whose case was rejected by other hospitals but who was made cancer-free at its facility.
The Cleveland Clinic is a master at such ads. A recent commercial featured a woman whose heart was failing. She told viewers the clinic saved her life.
“No one else could figure out what was wrong with me,” she said in the commercial.
What’s wrong with that testimonial?
“The problem with these ads is they may not be giving a realistic picture to people who have serious life-threatening cancers and other diseases and suggest that survival, if not certain, is at least likely” at the hospital sponsoring the ad, Arthur Caplan, a professor of bioethics at New York University Langone Medical Center, said.
Those ads are misleading, Caplan told me. He explained that many ads push individualized or personalized medicine, so patients think that the medications or treatments are designed specially for them.
“They give the impression there’s a pharmacy up in the attic brewing up a medicine just for you,” Caplan said.
That’s deceiving the patients, Caplan said.
“It’s cruel to suggest you’re getting something special or otherwise unattainable when that’s not the case,” he said.
These ad campaigns designed to make patients think favorably of a hospital are part of a larger campaign to build brand recognition much like detergent or cereal makers do.
“Medicine is mainly being treated like a business,” Caplan explained. “More and more, people are treated as customers, and doctors are treated as providers. You’d be a sap if you don’t advertise. I see a lot of cut-throat competition.”
Such brand recognition advertising is especially important when what Caplan calls the “mother ship hospital” buys smaller facilities in other locations as a way to bring in more patients. When people live in communities where, say, a hospital like New York’s Mt. Sinai or the Cleveland Clinic has bought a satellite facility, they’ll think favorably about someday being a patient at the local affiliate.
But are care and outcomes at the satellites the same as they are at the original location, either good or bad? Patients can never tell from the advertising. A recent study published in the JAMA Network Open found that the likelihood of surviving complex cancer surgery appears to be greater for those who had the procedure at the top-ranked hospitals than at their affiliates.
Until patients know more, the best advice is to take hospital advertising with a grain of salt. Do research personally when in a situation where a patient can make a choice – many people can’t – using the Medicare Hospital Compare website and any state information. Consider information on www.leapfroggroup.org, a nonprofit patient safety organization, to help with the decision-making.
What is important to you when choosing a hospital? Write to Trudy at firstname.lastname@example.org.