How to Keep Health Care Marketing Ethical

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Dr. Sung-Yeon Park, Professor of the School of Public Health at the University of Nevada, Reno

Americans spent $3.65 trillion on health care in 2018, which equates to $11,212 per person. With that much money at stake, it’s no wonder health care marketing and advertising is big business. In fact, Reuters reported earlier this year that annual health care marketing spending in the U.S. skyrocketed to $29.9 billion — or more — in 2016, up from $17.7 billion in 1997.

On one hand, health care marketing can help remove the stigma of certain ailments, such as mental illness, impotence and HIV/AIDS, and educate patients about their treatment options. On the other hand, it can also introduce information that leads to mis- and overdiagnosis, false hope in patients and overtreatment by health care professionals.

In an effort to mitigate these risks, Dr. Sung-Yeon Park, Professor in the School of Public Health (on-campus) at the University of Nevada, Reno, has researched how to keep health care marketing ethical, focusing on the cosmetic surgery industry in particular.

“There is more documentation about cosmetic surgery marketing than any other specialty marketing that I know of,” Park says. “You can see all the good things about cosmetic surgery [in the advertising], but anything referencing risks is absent from most talk.”

So, how can professionals keep health care marketing ethical? This article explores examples of harmful health care advertising and marketing practices and examines some of Park’s ideas about how marketing can be ethical and helpful while still selling products and services.

Examples of Unethical Health Care Marketing

There are several ways in which health care professionals can employ unethical advertising and marketing. For example, they might play on patient fear and vanity, minimize risks or exaggerate effectiveness. The following instances describe situations in which marketing strategies can cause potential harm to patients.

“Vampire” Patients

The American Medical Association’s Journal of Ethics offers an example of a recent fad promoted on social media sites: the “Vampire Facelift.” The advertisement featured a procedure that entailed injecting a patient’s plasma into his or her skin with microneedles to “stimulate the skin’s own regenerative properties.” It offered patient testimonials (all positive) and touted a month-long sale on the procedure.

The AMA asserts that this type of direct-to-consumer (DTC) advertising can give potential patients a false sense of trust in a doctor before an in-person meeting ever takes place. It also allows advertisements to be published without fully disclosing the risks; one recent study found that only 40% of U.S. plastic surgeons report potential procedural complications.

Photoshop Faux Pas

In 2014, an ad featuring “before” and “after” photos of “Noah,” an “actual patient” at a cancer care center, went viral. The “before” shot depicted a pale and sickly child, while Noah’s color and health appeared markedly better in the “after” shot. The ad was meant to show the miracle of the cancer center’s medical treatment, but what it actually showed was the magic of makeup.

The ad caused a subsequent backlash when it came to light that Noah’s pre-treatment photo had been doctored to make him look sick when he had been cancer-free for several years. While the ad did state that Noah was now “living cancer free,” nowhere did it communicate that Noah’s appearance had been altered. As a result, viewers didn’t feel the hospital was being truthful in its depiction of Noah’s condition, and the lack of disclosure caused some news publications to wrongly assume the photos depicted the boy’s recovery progress.

Celebrity Endorsements

In the age of social media saturation, specifically Instagram, “influencers” have emerged as one of the newest celebrity types. Many social media celebrities are selling medical procedures and pharmaceuticals to the public through partnerships with health care companies. For example, Louise Roe, a British “fashion journalist, TV host and new mum,” has 700,000 Instagram followers and is paid by biotechnology company Celgene to endorse Otezla, a psoriasis medication.

The concern with this type of advertising is that consumers will associate the product being sold with an influencer’s overall persona, leading to unattainable expectations. For example, Roe’s Instagram feed doesn’t discuss the symptoms of her psoriasis, explain that results vary among patients or outline the risks involved with using Otezla.

How to Keep Health Care Marketing Ethical

Health care advertising is here to stay. As a result, the Society for Healthcare Strategy and Market Development (SHSMD) revamped its guidelines and code of ethics for marketing, including updating its standards for bloggers and social media advertisers. These updates are part of the organization’s efforts to standardize truth and accuracy and protect patient rights while also promoting health care products.

“In the market-based system like what we have in the U.S., healthcare is a business, so you have to pay the bills, you have to pay the staff, and there has to be some money to take home,” Park says. “We want to use marketing in a way that will let patients know the available services and options in the area. Researchers need to offer guidance on how to market ethically by providing insight and criticism on the marketing strategies used for services that lack sufficient scientific backing.”

Though creating profit is necessary, it can also lead to unethical behavior from health care providers, Park explains. She cites a study of 10 university hospitals that found a pattern in the procedures they marketed.

“They tend to promote a lot of lucrative and profitable procedures, whereas they do not promote the day-to-day health care or cures for illnesses that are not profitable,” Park says. “They focus a lot of high-margin, high-tech procedures. They tend to ignore services that don’t make money.”

Park says she’s teaching her students the importance of ethical marketing and its impact on consumers.

“I want my students to learn the best marketing practices in health organizations and how they can best promote their organizations without creating distrust among their patients and care providers,” Park explains. “The marketing budget can be used to educate patients. That is the type of promotion patients actually like; they like to learn from their doctors and build trust. It’s a long-term relationship where the social media and advertisement can be used to build rather than damage trust.”

Here are a few tips on how to best market and advertise health care:

  • Maintain patient anonymity
  • Make realistic claims and promises
  • Develop policies for advertising
  • Ensure the marketing does no harm
  • Examine and identify unintended adverse effects

Want to Learn More?

Ethics in health care marketing is just one of many areas public health students can choose to focus on. If you’re interested in learning more about public health education programs, read about the online Master of Public Health in Public Health Practice at the University of Nevada, Reno and consider pursuing a career in an exciting field.


Suggested Readings

Why Health Care Professionals Need to Pay Attention to How Their Services Are Marketed

Key Issues in Advertising That Impact Public Health

University of Nevada, Reno Online Master of Public Health



ABC News, “Viral Cancer Ad the Result of Makeup and Bald Cap”

Aesthetic Surgery Journal, “Online Marketing Strategies of Plastic Surgeons and Clinics: A Comparative Study of the United Kingdom and the United States”

AMA Journal of Ethics, “When Is Advertising a Plastic Surgeon’s Individual ‘Brand’ Unethical?”

Becker’s Hospital Review, “3 Core Legal Issues for Hospital Marketing Programs”

Commexis, “Marketing Ethics for Healthcare”

Fortune, “U.S. Health Care Costs Skyrocketed to $3.65 Trillion in 2018”

Oxford Research Encyclopedias, “Ethical Issues in Health Promotion and Communication Interventions”

Society for Healthcare Strategy and Market Development, Code of Ethics

Reuters, “U.S. Health Care Industry Spends $30 Billion a Year on Marketing”

Vox, “The Latest Instagram Influencer Frontier? Medical Promotions”