Canada's plastic surgeons have decided to update their advertising guidelines, in part because of the burgeoning impact of social media.
"It has become increasingly common that the Board is asked to adjudicate whether 'advertising' meets the society's current ethics guidelines," Dr. Douglas Ross, then president of the Canadian Society of Plastic Surgeons (CSPS), commented in his 2012-13 report to members. "In fact, current CSPS guidelines pre-date the Internet and social media."
As a result, says Ross, the society - an affiliate of the CMA - is going to "reassess and modernize" the guidelines.
Dr. Jeff Blackmer, the CMA's director of ethics, says that decision is one more sign of social media's growing impact. "The arrival of Twitter, Instagram, Facebook and so on has created this brave new world in which individuals have unfettered access to new communication tools that allow new forms of advertising.
"None of us knows what the final impact will be, but we're already seeing brick-and-mortar institutions like newspapers replaced by electronic institutions such as Facebook. All we know for certain is that change is coming."
About 10% of the CSPS Code of Ethics, which was last updated in 2001, is devoted to advertising. That section spells out the information that can be provided through "public communications media such as professional announcements, telephone and medical directories, computer bulletin boards, Internet web pages and broadcast and electronic media."
The society's current advertising guidelines provide 10 suggestions for information that may be contained in "ethical advertising," ranging from a statement on office hours to a list of schools the surgeon has attended.
Members are advised that their advertising may employ photos of models, but if the models have not received the services being advertised, "the advertisement shall clearly and noticeably state [this]."
As well, CSPS members must not pay media representatives "in anticipation of or in return for recommending the member's services or for professional publicity."
The CMA's own Code of Ethics does not mention advertising directly, but one of its 54 sections states: "Avoid promoting, as a member of the medical profession, any service (except your own) or product for personal gain."
The underlying ethical precept, said Blackmer, is that physicians should not be using the trust patients have placed in them to promote the sale of drugs and medical devices. When it comes to promoting their own services, however, the lines are more blurred.
He isn't surprised that the CSPS intends to revise its guidelines. "Do phone companies even publish telephone directories anymore?" Blackmer asked, referring to the society's existing advertising rules.