In today’s rapidly evolving health care system, professional responsibility involves encouraging patients to actively participate in their own care and take personal accountability for their health—something that is particularly applicable to patients who have vascular disorders. The influx of new technology in health care offers some exciting and vastly improved therapeutic options for treating vascular disorders, especially for patients with chronic or complex conditions. Vascular specialists have an unprecedented opportunity to incorporate new technologies into their marketing and treatment plans while fostering patient participation in their own outcomes.

Coinciding with the technology surge is a significant increase in patient access to information, as well as extensive web-based marketing of new therapies. Research shows that Americans are avid users of the Internet for health care matters, and as a consequence, many patients believe they are experts after a brief Google search and might then present to their surgeon demanding a particular device or procedure. However, not all new medical advances will truly promote better health, and in some instances, new digital tools may lead to irresponsible marketing of risks versus benefits to patients.

PHYSICIANS’ RESPONSIBILITIES

Doctors, patients, device companies, payers, and policy makers are the stakeholders at this health care table, and there are often conflicts of interest that can drive misinformation. Ultimately, it is the physicians’ responsibility to use their knowledge to save lives, as defined by the Hippocratic Oath. As a result, there are ethical constraints for taking advantage of online marketing strategies in the medical field. Although the American Medical Association has an extensive code of ethics, it does not specifically address the issue of marketing to patients. The American Medical Association Code of Ethics1 requires that members conform to three ethical norms of conduct and six ethical values, which may be applied to marketing. The three ethical norms are (1) marketers must do no harm, (2) marketers must foster truth and trust in the marketing system, and (3) marketers must embrace, communicate, and practice the fundamental ethical values that will improve consumer confidence in the integrity of the marketing exchange system. The six basic values include honesty, responsibility, fairness, respect, openness, and citizenship.

In a move to educate consumers, many doctors are developing educational websites about the services they offer. Marketing your brand, practice, and chosen technologies cohesively and responsibly will benefit your practice and your patients alike. Gaps in understanding, either by the patient or the medical professional, must be exposed so that they can be bridged with enhanced communication. It seems that medical professionals and their patients are always excited to embrace something new. Often, new technologies enter mainstream use without going through the scientific “grinder” (ie, well-designed clinical trials). Physicians must be responsible in communicating the truth about the benefits and the risks when offering procedures with new devices.

UTILIZING DIGITAL TOOLS

Incorporating social media into marketing can lead to better self care and improved health. Examples include sponsoring a Facebook group for patients with the same type of vascular condition or using personalized text messages to encourage healthy behavior choices for patients prone to blood clots. The CareWeb app integrates health information streamed from multiple sources into a discussion thread, providing patients and medical care providers with a convenient, user-friendly venue for discussion and decision making. One of the best ways to ensure a good match between patient and technology is to research what patients say matters most to them. The website PatientsLikeMe.com offers a vast amount of information about real patients’ experiences—what helped, what worked, what didn’t—to help doctors avoid overhyping or making unrealistic promises.

Developing virtual clinics, introducing automated patient monitoring systems, and centralizing back-office functions are among the ways United States health care providers are reducing their cost structure while offering high-quality care. As an example, wearable sensors, data-driven software, portable diagnostic equipment, and mobile health care apps all aim to streamline patient-provider communication. Moreover, physicians can offer value-added services, which will likely result in gaining new patients. Some physicians feel stripped of financial opportunity because of overreaching control by the insurance industry and regulators. Therefore, some doctors are moving toward a direct payment system in an effort to gain some financial control over their service line. Some operators are posting the cost of certain procedures online, including out-of-pocket expenses, in a move toward greater transparency. Providers can coordinate care and individually tailor more effective treatments, and patients can obtain their care in more convenient and economical ways.

Digital tools are enabling both doctors and their patients. An elderly person with impaired heart function who lives alone could use a pulse oximeter and blood pressure cuff to transmit his or her data via telephone to a nurse as often as deemed necessary. The patient gains understanding and confidence in managing his or her own condition, and the anxiety is assuaged by a personal connection with the health care professional. Providers are also better able to treat a problem as soon as it emerges, rather than waiting for a scheduled office visit. One cloud-based platform for a smartphone or tablet, called Care at Hand, collects data from various health professionals about current symptoms, life changes, and personal impressions of a patient’s health. A series of prompts is then generated by an algorithm that helps doctors detect, combine, and analyze related symptoms that may indicate a safety risk or downturn in the patient’s health. Physicians can also contribute to the patient’s overall well-being by directing other concerns such as insufficient food, heat, transportation, or childcare options to the appropriate agency or organization.

CONCLUSION

The health care space is rapidly changing, and multiple challenges have resulted in aligning new technologies with patient care. Appropriate information must be responsibly communicated to patients in any marketing strategy. Patient safety and quality of care come first and foremost. A second priority is to offer care that fits into a reduced-cost structure.

Jose I. Almeida, MD, FACS, RPVI, RVT, is Voluntary Professor of Surgery at the University of Miami School of Medicine and Director of the Miami Vein Center in Miami, Florida. He has disclosed that he is a managing member of Vascular Device Partners. Dr. Almeida may be reached at jalmeida@miami.edu.

Victor A. Sirgado is President and CEO of Paramount MD in San Anselmo, California. He has stated that he has no financial interests to disclose. Mr. Sirgado may be reached at victor@paramountmd.com.

  1. American Medical Association. American Medical Association principles of ethics. http://www.ama-assn.org/ ama/pub/physician-resources/medical-ethics/code-medical-ethics.page. Accessed March 2015.