Advertising Ban for Doctors and Private Hospitals

The Advertising Board Connected to the Ministry of Trade publishes a comprehensive bulletin every month regarding the decisions it makes. This bulletin contains details about the decisions made by the Board during that month. Without exception, a significant portion of this bulletin each month consists of penalties related to advertisements by doctors and private hospitals. In this article, we will discuss the scope of the advertising ban in the healthcare sector and the perspective of the Advertising Board through concrete examples.

1. Advertising Ban

The issue of whether doctors can engage in advertising is a historical debate with philosophical and sociological aspects. In most countries around the world, it is considered unethical and illegal for doctors to advertise their services. In the United States, the ban, which lasted until 1975, was lifted when the Federal Trade Commission (FTC) ruled that the American Medical Association’s (AMA) ban on doctor advertising was illegal. AMA strongly reacted to this decision, arguing that advertising was antithetical to the professionalism of the medical profession and that doctors should not solicit patients. They believed that patients should seek medical care based on need rather than advertising.

Despite the practice in the United States, the regulations in the European Union and Turkey remain conservative. According to the existing legislation in our country, it is explicitly prohibited for doctors and dentists to advertise, except for sharing explanatory information.

2. Prohibitions and Exceptions

According to the regulations, doctors and dentists can only include their name, surname, address, specialization, academic title, and examination days and hours in their promotions and advertisements. Private hospitals, on the other hand, cannot engage in behaviors that violate medical ethics and professional ethical rules, mislead people, provide false guidance, or create demand, and they cannot engage in promotional activities that suggest they accept and treat patients in specialization fields not listed in their licenses, thus creating unfair competition against other hospitals.

In conclusion, the promotions expected from the healthcare sector by the legislation should not go beyond being explanatory and informative, and they should not aim to create demand. The Advertising Board also explains the advertising ban in the healthcare sector as follows:

(…..) according to the legislation in force in the field of health, while it is possible for physicians and dentists to publish advertisements that only include their names, the specialties recognized according to the Regulation on Medical Specialization, academic titles, and the locations where they accept patients and examination hours, any form of advertising and announcements, apart from this, are explicitly and definitively prohibited.

Similarly, institutions operating in the field of health are only allowed to provide information to the public about their opening information, service areas, and the services they provide, in accordance with the relevant legislation they are subject to. Beyond this, statements aimed at creating demand and statements that are misleading, exaggerated, and not scientifically proven are prohibited.” (Advertising Board Decision D. 2020/3865, No. 315, Date 9.11.2021)

3. Advertising Ban in Practice

People who see doctors and private hospitals advertising on the streets, on television, in print media, and especially on social media may be surprised that there is a strict advertising ban in the regulations. Indeed, it is possible to come across healthcare advertisements on any social media platform that are no different from advertisements for any other product or service. The claims made in these advertisements seem endless. So how is this possible?

Since the early 2000s, the number of private hospitals has increased by 100%, and their share among total hospitals has significantly grown. In addition, the spread of the “healthy living” culture, the growth of health tourism, the increase in aesthetic concerns, and the explosion of social media have rendered the medical ethics debates put forth by the American Medical Association in 1975 obsolete. Although the regulations are quite strict, supervision and penalties in practice are limited. However, doctors and private hospitals still need to be very cautious in the face of such strict regulations. Because when a dispute comes before the Advertising Board, a penalty is very likely to be imposed.

For example, in its routine meeting held on 09.05.2023, the Advertising Board issued immediate cessation penalties to 20 doctors for violating the advertising ban, and imposed administrative fines of 347,128 TL on 2 doctors. In addition to this, various amounts of administrative fines were imposed on 4 private hospitals, and cessation penalties were imposed on two private hospitals.

4. Approach of the Board

In this section, we will try to convey some concrete examples of what the Board considers as a violation of the advertising ban. As can be understood from these decisions, if any doctor or private hospital becomes subject to the scrutiny of the Board, there is a very high probability of them being penalized for violating the advertising ban.

In the “Patient Testimonials” section, expressions of thanks, praise, and approval by patients. (Advertising Board Decision D. 2019/11267, No. 305, Date 12.1.2021)
Stating, “No examination fee is charged for SGK patients.” (Advertising Board Decision D. 2011/1129, No. 198, Date 20.3.2012)
“30% Discount on (…) Filling & Botox Campaign.” (Advertising Board Decision D. 2021/590
“We invite you to experience quality and reliable healthcare services in Turkey’s best hospitals. Equipped with the latest technology, our hospitals, clinics, and health centers, along with our world-renowned doctors and hospitable staff, are committed to providing you with the best healthcare services.” (Advertising Board Decision D. 2015/1860, No. 247, Date 12.4.2016)
“The Best with the Best Service” (Advertising Board Decision D. 2012/652, No. 224, Date 13.5.2014)
“Doctor to the Celebrities: Dr. Y, who has performed hair transplantation for many celebrities, including famous football player X, also has patients from Kocaeli for this procedure.” (Advertising Board Decision D. 2015/1853, No. 247, Date 12.4.2016)
“Cupping therapy is one of the valuable blessings that has come from ancient times to the present day. An exceptional practice applied for the well-being of the entire body, cupping is supported by modern medicine and is a treatment method recommended by the Prophet Muhammad (peace be upon him) for his own health and for his ummah.” (Advertising Board Decision D. 2021/3762, No. 320, Date 12.4.2022)

5. Administrative Fines and Disciplinary Sanctions

In case of non-compliance with the legislation, administrative fines as specified below may be imposed in accordance with Article 77 of the Consumer Protection Law:

If it has been realized through a local television channel, 69,411 TL
If it has been realized through a nationwide broadcasting television channel, 1,388,526 TL
If it has been realized through a local or satellite radio channel, 34,701 TL
If it has been realized through a nationwide broadcasting radio channel, 347,128 TL
If it has been realized through a satellite television channel or the internet, 347,128 TL
If it has been realized through short message service (SMS), 173,553 TL
If it has been realized through other media (such as billboards), 34,701 TL.

In addition, disciplinary sanctions stipulated in their own regulations may also be applied to doctors and private hospitals.

REFERENCES:

ÖZDEMİR, S: Sağlık Hizmetlerinde Reklama Yönelik Sınırlandırmalar ve Hukuki Sonuçları, TAAD, Yıl:9, Sayı:34 (April 2018)

NY Times – F.T.C. Charges Illegality In Curb on Doctors’ Ads (1975)

Advertising Board Decision Bulletins

Ministry of Health Health Statistics Yearbooks – 2021