In the past the Health Professions Council of South Africa (HPCSA) did not permit medical practitioners to advertise their professional services. Although the reason for this is not entirely clear, it seemed that advertising was seen as incompatible with the dignity of the profession and with patient care.
As time passed, advertising by medical practitioners became increasingly viewed as permissible, largely due to a change in attitude, on the part of Society and the Legislator, towards fair competition. It became accepted that, to some extent, it is reasonable and even necessary for doctors to use advertisements to make the general public aware of the medical services available and the presence of medical practitioners in an area. The purpose is not for the practitioner to invite attention to himself/herself but for the benefit of the public.
Presently, advertising by medical practitioners is acceptable, albeit within the bounds of fairly strict ethical rules imposed by the HPCSA. Despite advertising being allowed, many medical practitioners elect not to advertise, however, for fear of criticism by the professional board which may affect one’s professional reputation. The question which arises, therefore, is how a medical practitioner may advertise within the confines of the ethical rules.
The following is stated in Booklet 2 of the Ethical and Professional Rules of the HPCSA of September 2016: “…A practitioner shall be allowed to advertise his or her services or permit, sanction or acquiesce to such advertisement: provided that the advertisement is not unprofessional, untruthful, deceptive or misleading or causes consumers unwarranted anxiety that they may be suffering from any health condition. A practitioner shall not canvass or tout or allow canvassing or touting to be done for patients on his or her behalf…”.
The HPCSA’s strict rules against canvassing or touting raises concern as to what constitutes canvassing or touting and how this can be differentiated from permissible advertising.
Canvassing is defined as “…conduct which draws attention, either verbally or by means of printed or electronic media, to one’s personal qualities, superior knowledge, quality of service, professional guarantees or best practice…”.
Touting is defined as “…conduct which draws attention, either verbally or by means of printed or electronic media, to one’s offers, guarantees or material benefits that do not fall in the categories of professional services or items, but are linked to the rendering of a professional service or designed to entice the public to the professional practice…”.
In addition to the above, the HPCSA published guidelines on social media on its website which are also relevant to advertising (https://www.hpcsa-blogs.co.za/advertising-guidelines-for-practitioners/). The following is stated:
“…Touting involves drawing attention to one’s professional goods or services by offering guarantees or benefits that fall outside one’s scope of practice. An example is advertising free wifi services to patients while waiting for their consultation…”
and
“…Canvassing involves the promotion of one’s professional goods and services by drawing attention to one’s personal qualities, superior knowledge, quality of service, professional guarantees, or best practice. An example of canvassing is a healthcare practitioner declaring on social media or posting patient reviews that state that he or she is “the best health practitioner in the country…”.
The HPCSA rules are not specific about what is deemed to be acceptable advertising. The South African Medical Association (SAMA) however, sets out guidelines which practitioners could follow in the absence of clarity from the HPCSA. These state as follows:
- It is acceptable to publish tariffs on advertisements, provided that they are factual;
- Graphics (such as an anatomical structure) or a photograph of the medical practitioner are acceptable, provided that they are not indecent, deceptive, misleading or brings the profession into disrepute;
- Excessively large notices or sign boards outside the practice could constitute unprofessional conduct;
- Advertisements in colour appear to be acceptable;
- Direct mailing of advertisements/pamphlets with factual information appear permissible, however, bulk distribution may be construed as unreasonably drawing attention to the practice;
- A practitioner should avoid using phrases such as, “conditions apply”, in advertisements.Such conditions should be specifically stated at all times.
The above is only a guideline and practitioners are reminded that complaints relating to unprofessional advertisements will be considered by the HPCSA on their individual merits. SAMA reiterates the aforementioned in order for practitioners to understand that they need to exercise great caution when advertising.
From the above, it is clear that there is a fine line between what is permissible and what is not. If a medical practitioner is uncertain about whether something in particular is appropriate or not, it would be advisable rather to err on the side of caution and query this with the HPCSA in advance, to avoid an adverse outcome.
