Change is inevitable

The practice of medicine has undergone many changes over the years and will continue to undergo many more changes – in concepts and in practice – in future. It is, therefore, unrealistic and unfair to expect the medical profession to accept and adopt all of the ethical principles that were laid down years ago (1). Modifications must be made by the governing bodies and physicians must accept the changes.

I propose that — as is the practice in the United States — doctors in India should be allowed to advertise their services. Before I proceed further, let me make it clear that I would personally not advertise: either because I find it difficult to totally shake off old, established beliefs or because my own field (pathology) does not require advertising. However, I would defend the right of other physicians to advertise.

Dr Pandya argues that medical professionals have peer-reviewed journals to produce their research papers in and thus ‘advertise’ themselves to their peers. However, as he himself has pointed out some years ago (2), Indian doctors rarely publish. Moreover, Sahni et al (3) showed some years ago that only five per cent of Indian doctors read medical journals. This avenue of spreading information about oneself is thus blocked for most physicians.

The argument has been made that allowing advertising will permit doctors to make tall claims. The cure, then is to make our medical councils, advertising agencies, and the Advertising Standards Council of India more accountable. Preventing advertising because of the existence of misleading advertising is like banning cricket because of some matches are fixed. The solution is to prevent the fixing, not the game.

Finally, the change in medicine is exemplified by the fact that many hospitals, especially the private or corporate ones, have marketing departments. There have even been suggestions that the word ‘patient’ be replaced by ‘client’ or ‘customer’ (4).

But this much is clear: change is inev itable. In an age when patients are considered to be consumers and when doctors can be sued for poor services, surely it is incorrect not to allow doctors to advertise. The same rules have to apply to all the players of the game.