October 4, 2000
      By HANNAH MILLER
      COURIER TIMES

Pressured by managed care, a shrinking number of uninsured patients, and widespread financial woes, the healthcare industry is increasingly doing something once considered unethical to attract patients: advertising.  Nationwide, hospitals' advertising budgets increased 60 percent between 1996 and 1998, from $328,940 on average per hospital in 1996 to $529,590 in 1998, according to researchers at ORC International.  That works out to between $100 and $1,000 per hospital bed for direct mail, TV ads, radio spots and to pay marketing firms to make sure hospital doctors are quoted as experts, according to the ORC report.  Advertising and marketing in the healthcare field isn't new, but it has exploded in the last 10 years, according to experts. Since 1977, when the American Medical Association decided that any honest form of advertising was OK, doctors have had to figure out how to sell themselves to the public.  They also have to sell themselves to other doctors, so they will refer patients who need a specialty physician. And they have to sell themselves to insurance companies to become part of the provider network.  "It's becoming such a competitive environment, they need to stress their strengths, and position themselves as experts," said Leza Raffel of Communication Solutions, a marketing firm in Doylestown with several healthcare clients, including the Eye Institute at the Pennsylvania College of Optometry, a dentistry group in Springhouse, a fertility clinic in Wayne, and a hydrotherapy group in Philadelphia.  The hardest part about coming up with the public advertising campaigns, according to Raffel, is getting the patients to agree to give their testimonial.  "People who are watching are less interested in the procedure than the outcome," said Raffel. "They don't want to see how hydrotherapy works, they want to see the 50-year-old who avoided knee replacement surgery because of it."  "The most consistent advertisers are the large hospitals like Temple University Healthcare Systems Allegheny Healthcare Systems, who can build a 'brand name' through affiliations and billboards. The American Association of Medical Colleges even sponsors an annual contest for the best marketing campaign mounted by a hospital.  If they are lucky enough to be members of these groups or networks, doctors don't have to do any advertising at all. Likewise, if they have been practicing for years and have a strong patient base.  But for fledgling practices like Scott Cohen's, a Northampton family physician who decided to set up his own shop two years ago, it's essential.  Going out on his own has required him to set aside an annual advertising budget. The Holland doctor doesn't like to talk about it - he still feels a little uncomfortable after years of medical practice. But he says it has worked.  "I've found that many of my patients saw one of my brochures six months ago," said Cohen, who used to work for Allegheny Healthcare Systems. "Especially in areas with a lot of physicians, we have to do this a lot more."  Cohen said that his advertising budget basically covers an ad in the phone book and then some. "It's like a public notice: I'm here, I'm board certified, our practice is accepting new patients, I'm an intelligent and caring physician."