India's Advertising Dilemma

Rick Johnson, for HealthLeaders Media, March 18, 2008

As a developing nation, India has high hopes for its healthcare industry and the potential for medical travel. Overall, the government supports its growing private healthcare sector. However, the Medical Council of India maintains regulations barring physician and hospital advertising that--when taken at face value--are antiquated and anti-business.

For the past decade, as private healthcare organizations became more common in the region, the medical council has not enforced aspects of the Code of Medical Ethics that deem most forms of hospital and physician advertising as "unethical."

More recently, the Karnataka Medical Council warned practitioners of its position against advertising, as stated in the Code of Medical Ethics. KMC was moved to action because it had observed many hospitals advertising on a mass scale, including newspaper ads and billboards, the council's president told The Hindu newspaper.

In an e-mail conversation, Dharminder Nagar, MD, CEO of Paras Hospital, in Gurgaon, India, tells me that healthcare advertising in the nation is a fairly new phenomenon that has come about with the emergence of corporate, for-profit hospitals.

"As a hospital CEO, I believe the modern hospital marketing practices hold great value today and the need to implement these in the future will continue to grow," says Nagar. "Healthcare in India is at the cusp of explosive growth, and at the same time competition is bound to increase tremendously. Marketing of hospital services and differentiating the services for the public will become an important factor in attracting patients."

Some Indian hospitals carry on advertising their providers and services under the assumption that the medical council will continue turning a blind eye. Others don't wish to take the risk and instead seek alternative, legal methods. Nagar points out that holding public health programs and seminars that are promoted in local newspapers is a perfectly legal and effective way to promote Paras Hospital's services. "I believe that best international practices in hospital marketing will help us tremendously, but these need to be modified to suit the local legal and cultural context," he says.

Perhaps it's my cultural bias as a Westerner, but I still can't shake the feeling that this country's Code of Medical Ethics in its current form is too rigid and onerous. As an emerging industry in a developing country, India's private hospitals face many obstacles, from adopting the latest technology and medical procedures to attracting and maintaining clinical staff.

To support the growth of this business sector, hospital CEOs should be urged to embrace modern business practices that include promoting their services to the public, so long as the content of these messages is ethical and factual. Instead, the medical council retains a code that is anti-business and perhaps impossible to enforce. This invites noncompliance and, as a byproduct, punishes those institutions that abide by the regulation.

Moreover, the spread of talent and technology is not enough to globalize the business of healthcare. Governments worldwide need to support the industry, and healthcare institutions need to promote best practices in health system administration. The end result will be better choice of healthcare providers as well as better access to state-of-the-art healthcare.

As for those best-practices in healthcare marketing, I wrote about what some of the top U.S. health systems are doing in HealthLeaders magazine last year. That was an article I took pleasure in writing because I consider myself something of a life-long student of communication. It troubles me when others hold views that marketing and advertising are by their very nature unethical.

No, advertising and marketing can both support the business of healthcare and provide the pubic with tools to make informed decisions. There's nothing unethical about that.

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Rick Johnson is senior online editor of HealthLeaders Media. He may be reached at
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