Medical professionalism and ethics of medical information dissemination, what is permitted and what is not. Grey areas abound but care must be taken to ensure that the physician does not run foul of the Code of Professional Conduct of the Malaysian Medical Council (MMC), although some of the restrictions may be modified and relaxed over the next few months. Advertising in discount sites are prohibited as this is usually tantamount to fee-splitting frowned upon by almost all medical boards. Gross infringement of these guidelines might lead to MMC sanctions which include suspension or removal of rights to practice. Different nation's medical boards have different constrictions of medical advertisement, some of these are compared with our own local MMC.

1. Dissemination of Information By The Medical Profession:
Is There A Need To Amend Our Current Regulations &
Code Of Practice?
Dr David KL Quek,KMN
MBBS (Mal), MRCP (UK), FRCP (Lon), FAMM (Mal), FCCP (USA),
FNHAM (Mal), FASCC (ASEAN), FAPSC (Asia Pacific) FACC (USA), FAFPM (Hon)
Elected MMC Member 2004-2016
Senior Consultant Cardiologist,
Pantai Hospital Kuala Lumpur
Seminar on Vetting of Medicines Advertisement
Dewan Serai Wangi, Bahagian Perkhidmatan Farmasi,
Lot 36, JalanUniversiti,
46350 Petaling Jaya, Selangor.
29 October 2013

2. THE CODE OF PROFESSIONAL
CONDUCT AND GUIDELINES In
RELATION TO THE MEDICAL
ACT



The practice of Medicine is an ancient profession and
the community has great expectations of its
practitioners and places great trust in them.
Without this trust it would be impossible to practise
medicine and the profession expects a high standard
of professional and personal conduct from its
members.
These are embodied in various Codes of Ethics,
which vary in detail from country to country, but all
place first and foremost the health and welfare of the
individual and the family under the care of a
practitioner.

3. THE CODE OF PROFESSIONAL
CONDUCT AND GUIDELINES In
RELATION TO THE MEDICAL
ACT

The Medical Act 2012 is the legislation relating to the
registration and practice of medical practitioners and
the Medical Regulations to the Act empower it, to deal
with all disciplinary matters involving registered
medical practitioners.

The Code of Professional Conduct of the Malaysian
Medical Council provides the yardstick for the conduct
and behaviour of registered medical practitioners in
their clinical practice and in all areas of professional
activity.

4. 4. ADVERTISING,
INFORMATION AND RELATED
PROFESSIONAL MATTERS
The medical profession has long accepted the convention
that medical practitioners should refrain from selfadvertisement.
 In the Council‟s opinion self-advertisement is not only
incompatible with the principles which should govern
relations between members of a profession but could be a
source of danger to the public.
 A practitioner successful at achieving publicity may not be
the most appropriate doctor for a patient to consult.
 Patients who are suffering from a serious illness are
extremely vulnerable and advertising may raise illusory
hopes of cure.


5. 4.1 Advertising and Information


4.1.1 Advertising, whether directly or indirectly,
for the purpose of
 obtaining patients, or
 promoting the practitioner‟s own professional
advantage, or
 to gain advantage over market competition, or,
 for any such purpose, of procuring or
sanctioning, or
 acquiescing in, the publication of notices
commending or directing attention to the
practitioner‟s professional skill, knowledge,
services, or qualifications, or
 deprecating those of others, or

6. 4.1 Advertising and Information
4.1.1 Advertising, whether directly or indirectly,
for the purpose of
 obtaining patients,
 of being associated with, or employed by, those who procure
or sanction such advertising or publication, and canvassing, or
employing any agent, or tout, or canvasser, for the purpose of
obtaining patients, in any manner, channel or media; or
 of sanctioning, or of being associated with or employed by
those who sanction, or being a party to, abetting or condoning
such employment e.g. by private hospitals, clinics and other
medical institutions,
 are in the opinion of the Council, contrary to the public interest
and discreditable to the profession of Medicine.
 Any registered medical practitioner who resorts to any such
practice may be considered to have committed serious
professional misconduct.



7. 4.1 Advertising and Information



4.1.2 Providing Information in relation to the
medical profession, is the act by which a healthcare
provider disseminates factual information to the public
generally on health promotion and specifically on
diseases, their prevention, control and treatment, and
on any other aspects related to these modalities,
without the medical practitioner contravening the
ethical codes of professional conduct, or without any
designs to obtaining patients, profiting financially or,
appearing directly or indirectly, to promoting his own
professional advantage or product, or appearing to be
for these purposes.

8. 4.1 Advertising and Information



4.1.3
The Council recognises that the profession has a duty
to disseminate information about advances in medical
sciences and therapeutics provided it is done in an
ethical manner.
Exceptions are when the information is of a
confidential nature, or when it may be conceived to
cause public panic or to affect national security.

9. 4.1 Advertising and Information





4.1.4
A medical practitioners should not claim to be the best
or the only one in a particular field of practice or
specialty.
There are really no effective methods of determining
whether a practitioner can claim to be so.
Claims of „firsts‟ or „breakthroughs‟, although of
considerable public interest, are also contentious.
These types of announcements should not be made
by the practitioner involved.
It is best left to the academic and professional bodies
and officers so authorised to verify such claims and
make appropriate public announcements

10. 4.1 Advertising and
Information

4.1.5
A practitioner should avoid discussions in
the lay press on controversial points of medical
science, or any new procedures and treatment. Such
matters are more appropriate to medical journals and
for discussion in professional societies.

4.1.6
A practitioner providing medical information
in any media, including the electronic media, should
adhere strictly to established codes of conduct.
Frequent appearances by the same practitioner on
the media, is discouraged as these raise the
suspicion that the practitioner is seeking publicity for
personal benefit.


11. 4.1 Advertising and
Information and Health Tourism
 4.2 The Practitioner



Practitioners working in healthcare facilities which are
accredited to participate in health tourism, which may
necessitate the canvassing for patients in foreign
countries, may, under special circumstances, and
after approval from regulatory bodies in the Ministry of
Health, will be allowed to provide information in
brochures regarding their qualifications, experience
and expertise in special procedures.
Such brochures should only be distributed in foreign
countries.
Practitioners in such practice are still subject to the
Medical Act, the Code of Professional Conduct and
other related and relevant regulations when managing
foreign patients in Malaysia.

12. 4.1 Advertising and
Information
4.3
Announcement in the Lay Press
Regarding Practice
 An announcement by the Malaysian Medical
Association (MMA), or any other recognized
and approved professional body, on the
commencement or change of address of
practice is permissible as a service to the
community.


13. 4.1 Advertising and
Information





4.4 Articles, Contributions and Books for the Lay Public
4.4.1 It is permissible for the practitioner‟s name to be
published in articles, contributions and books for the lay public.
The name can be followed by a brief description of
qualifications and primary place of practice. These should not
be unduly emphasised by large or heavy type
4.4.2 There must not be any laudatory editorial references to
the practitioner‟s professional status or experience.
4.4.3 Where the publication has arisen as a result of research
on any instrument or drug provided by a commercial firm, this
should be stated and a disclaimer regarding any financial
interest of the author(s) with the firm be inserted.
4.4.4 Photograph of the practitioner in connection with articles
or contributions in the media are allowed. Photographs and
testimonials of patients are not allowed.

14. 4.1 Advertising and
Information





4.5
Lectures to Lay Public
4.5.1
A practitioner who proposes to deliver a lecture should
request the chairman beforehand to be circumspect in
any introductory remarks concerning his professional
status or achievements.
4.5.2
Publicity about the lecture can be in any media to inform
the public of the name and appointment of the practitioner
as well as the venue, date and time of the lecture. The
place of practice of the practitioner should not be
published.

15. 4.1 Advertising and
Informationto Colleagues
 4.6
Lectures
4.6.1
A medical practitioner may be in a position to
educate colleagues, or present some new method of
treatment or innovation. Such talks must be organised
only through professional bodies or hospitals and not
through pharmaceutical or equipment firms. The
practitioner must exercise caution when promoting a
particular drug or product and should declare to the
audience the practitioner‟s interest in the drug or product.
 4.6.2
Information about such talks may be circulated
through the professional bodies or hospitals only.
 4.6.3
The practitioner must caution against any
media reporting any unproven modalities of management
or treatment such that it appears that the practitioner
advocates such treatment to the public.


16. 4.1 Advertising and
Information

4.7
Press Interviews

4.7.1
Medical practitioners engaged in active medical
or surgical practice should avoid giving interviews
expounding their personal opinions on diseases and their
treatment to reporters of the print, electronic or airwave
media, except through an Association, an
authorisedorganisation or institution. (Amended at MMC
Meeting on 10/5/2005)

4.7.2
The medical practitioner in charge of the
authorisedorganisation assumes full responsibility for any
practitioner giving the interview and acting under its
auspices.

17. 4.1 Advertising and
Information




4.8
Professional Calling Cards, Letterheads and
Rubber Stamps
A practitioner may carry calling cards but should not
distribute calling cards with the purpose of soliciting for
patients.
The calling cards/letterheads should only contain the
name of the practitioner, registrable and accredited
professional qualifications, designation, state and national
awards, home, practice as well as e-mail address,
telephone and facsimile numbers.
Logos may be printed as long as they are appropriate for
a medical practitioner. A recent photograph of the
practitioner (passport size) may be allowed only on the
calling card.

18. 4.1 Advertising and
Information Calling Cards, Letterheads and
 4.8
Professional
Rubber Stamps
 Medical etiquette demands that medical practitioners be
circumspect about their qualifications, awards and
honours. It is permissible to list all registered and
accredited qualifications acquired by examinations or
following an appropriate period of supervised training.
 Practitioners must not print awards and honours awarded
by bodies other than the national and state governments.
 A medical practitioner may claim to practice as a
specialist in two closely related specialties, but this
information must be available on only the one and the
same calling card.

19. 4.1 Advertising and
Information
 4.9 Signboards



A signboard should serve to provide guidance and
information about a clinic. It should not be viewed as a
means of soliciting for patients. The use of a large
signboard to indicate a medical practice is considered
unethical in many parts of the world. However as the
custom is already prevalent in Malaysia and as a
signboard does help patients to find a doctor, it is
recommended that their use should continue, provided:
4.9.1
There shall not be more than two signboards
on the premises of the clinic to indicate the identity of the
practice.
4.9.2
Signboards may be illuminated in a style that is
appropriate for a medical practice.

20. 4.1 Advertising and
Information





4.9 Signboards
4.9.3
The total size of the signboard or signboards, if
there are two shall not exceed 3.0 sq. meters.
4.9.4
Where signs are painted on walls, the
perimeter of the lettering shall not enclose an area in
excess of those specified above.
4.9.5
When the practice is within a commercial
complex, there is no objection to the clinic name
appearing in the general directory signboard in the lobby.
4.9.6
The use of the Red Crescent/Red Cross
emblems on any private medical premise is not allowed.

21. 4.1 Advertising and
Information

4.10

The use of directional signboard/s, with the word “Clinic”
and an arrow pointing in the direction of the clinic leading
from the main road, is permissible.
The name of the clinic must not appear in such a
directional signboard, which should be within 1 km on the
main road before turning to the clinic.
Only two such directional signboards are allowed, one
each from each direction on the main road.


Directional Signboards

22. 4.1 Advertising and
Information





4.11
Name Plates/Doorplates
The name plates and door plates displayed outside a
practice, should be plain and not exceed 1,000 sq cm.
They may bear the practitioner‟s name, his registrable
qualifications, and titles, if any.
The consultation hours should be indicated on the same
name plate. If there is more than one practitioner working
in the same clinic, separate name plates will be permitted
for each practitioner and the above rules will also apply.
Visiting practitioners may have a name plate. Only those
practitioners working in the clinic are allowed name
plates.

23. 4.1 Advertising and
Information
4.12
24 Hour Clinic
 Notification of the availability of 24-hour professional service
should be on the door plate pertaining to consultation hours.
 A registered medical practitioner should be available at all
times in the 24-Hour Clinic.
 In the event that an emergency arises that requires the
practitioner to be called away, the practitioner should instruct
the clinic nurse to do the following:
 (1) to inform patients turning up that the practitioner is away
on emergency duty and is not available,
 (2) not to accept any new patients until the practitioner is
back in the clinic, and
 (3) arrange for the patient to go to the nearest clinic for
treatment where there is any degree of urgency.


24. 4.1 Advertising and
Information

4.13

A temporary banner to announce the opening of a new
healthcare facility may be allowed for the purpose of
public information. The size should conform to that
allowed for a signboard.
It should not be displayed for a period longer than one (1)
calendar month prior to the date of opening.
The banner is only permitted to be displayed at the
entrance to the premise.
It should only contain the date of the opening and the
name of the clinic or hospital. Any other information is
unethical.



Banners:

26. July 31, 2012

37. MOH, Singapore Medical Board
http://www.bioethicsinternational.org/blog/2011/10/19/guidelines-for-health-care-ads-outdated-under-review/

39. Are Corporate bodies (GLCs)
and public institutions exempt
from our advertising
regulations and code of
conduct?
Is it One rule for some and
another for others?
Is there a Level Playing field?
What about the profesisonal
ethical concerns?

40. KPJ HEALTHCARE, CARE FOR LIFE
TROPICANA
MEDICAL
CENTRE
6 km
TROPICANA
MEDICAL
CENTRE
3 km

42. When does business entrepreneurship begin and
medical professionalism end, or should it? Can a
medical doctor become a named product of business?

43. Claims of beauty or
herbal health products
as ‘best’, ‘effective’
targetted at the public,
from a Doctor…
Online sales
of health
products
linked to
doctor…

44. Use of testimonials from famous people,
newspaper advertorials, news with photos of
patients, laudatory commentaries….

45. Where’re the internet
boundaries?
Facebook friendly info
from a CEO of e.g.
UMSC…
Actual targetted
advertisement, with
related newspaper
article…

46. http://healthcare.groupon.my/
Today’s Deal →
All Groupon
Healthcare offers
have an approved
KKLIU number by
the Medicine
Advertisement
Board, Ministry of
Health Malaysia
Is this sort of advertisement allowed, or
consistent with the times of medical
information? Is there implied discount
when people respond to these early or
within a time frame given, as is wellknown with Groupon discounts?

49. Because Groupon‟s modus operandi or core practice
methods are based on profit sharing usually as much as
50% or more, this is construed as FEE SPLITTING and
therefore is UNETHICAL. No health advertisement can
use such a method of medical information dissemination.
Doctors who associate themselves with such practices
are deemed to be carrying out unethical practices and
therefore may be found to have breached the Code of
Professional Conduct of the Malaysian Medical Council
and may be sanctioned if found guilty!

50. Health care
and health
tourism as a
dollar
earner
NKEA for
MALAYSIA,
says YB
Health
Minister
Dato‟ Sri
Liow

52. The Medical Board of Australia Guidelines for
Advertising of regulated health services is one of
the most comprehensive document available…

53. „Extract of relevant provisions from the Health
Practitioner Regulation National Law Act 2009
(Qld)‟.

In particular, s. 133 of the Australian National Law states that
a person must not advertise a regulated health service, or a
business that provides a regulated health service, in a way that

(a) is false, misleading or deceptive or is likely to be misleading or
deceptive; or

(b) offers a gift, discount, or other inducement to attract a person to
use the service or the business, unless the advertisement also sets
out the terms and conditions of the offer; or

(c) uses testimonials or purported testimonials about the service or
business; or

(d) creates an unreasonable expectation of beneficial treatment; or

(e) directly or indirectly encourages the indiscriminate or
unnecessary use of regulated health services.

54. What is acceptable advertising?
Advertising used to inform the public of
the availability of regulated health
services may be considered to comply
with these guidelines if it is information
published in the public interest, and is
factual, honest, accurate, clear,
verifiable and not misleading.
 Examples of the type of advertising of
services that the boards consider to be
acceptable.


55. What is acceptable advertising?
Advertising may contain:





(a) a factual and clear statement of the service(s)
and/or any product(s) offered
(b) contact details of the office of the practitioner,
including email or website addresses, and
telephone numbers
(c) the gender of practitioners
(d) a statement of office hours regularly
maintained by the practitioner and the availability
of after-hours services
(e) for any surgical and/or invasive procedures,
the appropriate warning statement in a clearly
visible position

56. What is acceptable advertising?
Advertising may contain:





(f) non-enhanced photos or drawings of the practitioner or his or
her office
(g) advice on the availability of wheelchair access to any premises
to which the advertisements relate
(h) a statement of any language(s) other than English fluently
spoken by the practitioner or another person in his or her office
(this does not affect other guidance provided by the national board
about use of qualified interpreters where appropriate)
(i) a statement about fees charged, bulk-billing arrangements, or
other insurance plan arrangements and instalment fee plans
regularly accepted
(j) a statement of the names of schools and training programs
from which the practitioner has graduated and the qualifications
received, subject to Section 6.4, „Advertising of qualifications and
titles‟

57. What is acceptable advertising?
Advertising may contain:

(k) reference to any practitioners who hold specialist registration or
endorsement under the National Law and their area of specialty or
endorsement

(l) a statement of the teaching positions currently or formerly held by the
practitioner in board-approved or accredited institutions, together with
relevant dates

(m) a statement of the accreditation or certification of the practitioner with
a public board or agency, including any affiliations with hospitals or clinics

(n) a statement of safety and quality accreditation of the practice or health
care setting

(o) a list of the practitioner‟s peer reviewed publications

(p) any statement providing public health information encouraging
preventative or corrective care (public health information should also be
evidence based wherever possible).

58. Public Announcement of
Research Discoveries





In this era of rapid communication, intense media and public interest in
medical news, clinical investigators or their institutions commonly make
public announcements of new research developments.
Because media coverage of scientific developments can be fraught with
misinterpretation, unjustified extrapolation, and unwarranted conclusions,
researchers should approach public pronouncements with extreme caution,
using precise and measured language.
Press or media releases should be issued & press conferences held only
after research has been published or presented in proper and complete form
so that study details are available to the scientific community for evaluation.
Statements of scientists receive great visibility. An announcement of
preliminary results, even couched in the most careful terms, is frequently
reported by the media as a “breakthrough.”
Spokespersons must avoid raising false public expectations or providing
misleading information, both of which reduce the credibility of the scientific
community as a whole.

59. What is unacceptable
advertising?
Advertising Services must not:

(a) create or be likely to create unwarranted and unrealistic
expectations about the effectiveness of the health services
advertised

(b) encourage (directly or indirectly) inappropriate, indiscriminate,
unnecessary or excessive use of health services; for example,
references to a person improving their physical appearance and
the use of phrases such as „don‟t delay‟, „achieve the look you
want‟ and „looking better and feeling more confident‟ have the
potential to create unrealistic expectations about the effectiveness
of certain services and encourage unnecessary use of such
services

(c) mislead, either directly, or by implication, use of emphasis,
comparison, contrast or omission

(d) use testimonials or purported testimonials

60. What is unacceptable
advertising?
Advertising Services must not:





(e) compare different regulated health professions where
there is no evidence on which to base the comparison
and/or in a way that may mislead or deceive
(f) claim that the services provided by a particular regulated
health profession are better, as safe as or safer than others
(g) refer to the recovery time following provision of a
regulated health service that may lead to unrealistic
expectations
(h) lead to, or be likely to lead to, inappropriate selfdiagnosis or self-treatment
(i) abuse the trust or exploit a lack of knowledge by
patients or clients

61. What is unacceptable
advertising?
Advertising Services must not:





(j) fail to disclose that there are health risks associated
with a treatment
(k) omit the necessary warning statement (see Section 6.2,
„Use of warning statements for surgical or invasive
procedures‟)
(l) contain language that could cause undue fear or distress
(m) contain any information or material that is likely to make
a person believe his or her health or wellbeing may suffer
from not taking or undertaking the health service
(n) contain price information that is inexact, or fails to
specify any conditions or variables to an advertised price
(see Section 6.5, „Advertising of price information‟), or
offers time-limited discounts or inducements

62. What is unacceptable
advertising?
Advertising Services must not:

(o) contain any claim, statement or implication that
 either expressly, or by omission, that the treatment is
infallible, unfailing, magical, miraculous or a certain,
guaranteed or sure cure
 a practitioner has an exclusive or unique skill or remedy,
or that a product is „exclusive‟ or contains a „secret
ingredient‟
 a practitioner provides superior services to those
provided by other registered health practitioners
 the results of the health service offered are always
effective
 the services can be a substitute for public health
vaccination or immunisation

63. What is unacceptable
advertising?
Advertising Services must not:
(p) purport to inform the public fully of the risks of
undertaking a health procedure or to replace the process
of informed consent
 (q) provide a patient or client with an unsolicited
appointment time that has not been requested by the
patient or client
 (r) promote tobacco products, smoking, alcohol, or any
other addictive substances or products that are known to
affect health adversely
 (s) be vulgar, sensational, contrary to accepted standards of
propriety or likely to bring a health profession into
disrepute, for example, because the advertising is
sexist.


64. Use of graphic or visual representations



Practitioners should use any graphic or visual
representations in health service advertising with
caution.
This includes photographs of patients, clients or
models, diagrams, cartoons or other images. A
„photograph‟ in relation to the advertised treatment
includes images, graphic, or other visual
representations or facsimiles.
Practitioners should not use photographs of actual
patients or clients if the patient or client is vulnerable
as a result of the type of treatment involved or if their
ability to consent may be otherwise impaired.

65. Use of graphic or visual representations
Use of „before and after‟ photographs in advertising of
regulated health services has a significant potential to be
misleading or deceptive, to convey to a member of the
public inappropriately high expectations of a successful
outcome and to encourage the unnecessary use of health
services.
 If „before and after‟ photographs are used, care must be taken
to ensure:

 providing images that are as similar as possible in content,




camera angle, background, framing and exposure
ensuring consistency in posture, clothing and make up
ensuring consistency in lighting and contrast
stating if photographs have been altered in any way
confirming that the referenced procedure is the only visible
change that has occurred for the person being photographed.

66. Use of warning statements for surgical or
invasive procedures
Where a surgical (or „an invasive‟) procedure is
advertised directly to the public, the
advertisement should include a clearly visible
warning, with text along the following lines:
 ‘Any surgical or invasive procedure carries
risks. Before proceeding, you should seek a
second opinion from an appropriately
qualified health practitioner.’


67. Use of comparative advertising
It is difficult to include all required information to avoid a
false or inaccurate comparison when comparing one
health service or product with another.
 Therefore, comparative advertising is at risk of
misleading the public.
 If practitioners use any form of comparative advertising,
practitioners must not:
 make unsubstantiated claims, or
 deride or otherwise criticise the services or
products offered by another practitioner, or
 make sensational statements that cannot be
corroborated.


68. Advertising of qualifications and titles

A practitioner should state clearly his or her professional qualifications.
Credentials and a practitioner‟s expertise in a particular field should be
clear to the public.
Use of titles in advertising
 Section 117 of the National Law prohibits a practitioner from knowingly
or recklessly taking or using any title that could be reasonably
understood to induce a belief that the practitioner is registered in a
health profession or a division of a health profession in which the
practitioner is not registered.
 Section 116 of the National Law prohibits a person who is not a
practitioner from knowingly or recklessly taking or using a title that,
having regard to the circumstances, indicates or could be reasonably
understood to indicate the person is a registered health practitioner, or
authorised or qualified to practise in a health profession.
 Practitioners should avoid developing abbreviations of protected titles
as these may be confusing.
 There is no provision in the National Law that prohibits a practitioner
from using titles such as „doctor‟ or
 „professor‟.

69. Advertising of qualifications and titles
Advertising of specialties and endorsements
 Section 116 of the National Law prohibits an unregistered person
from claiming to be registered under the National Law or holding
himself or herself out as being registered under the National Law in
any of the regulated health professions.
 Section 115 of the National Law prohibits a person from knowingly
or recklessly taking or using a specialist title for a recognised
specialty unless the person is registered under the National Law in
the specialty.
 Section 118 of the National Law prohibits a person who is not a
specialist health practitioner from taking or using a title, name, initial,
symbol, word or description that, having regard to the circumstances
indicates, or could be reasonably understood to indicate, that the
person is a specialist health practitioner or is authorised or qualified
to practise in a recognised specialty.
 Section 119 of the National Law prohibits a registered health
practitioner from claiming:
 to hold a type of registration, or endorsement of registration
that they do not hold, or
 to be qualified to hold an endorsement they do not hold.

70. Advertising of qualifications and titles
Practitioners are encouraged to ask themselves the
following questions:





Why do I wish to use this title, qualification, membership, words
or letters in advertising material?
Am I well qualified in the areas of practice that I offer and
promote with these words?
Is the basis for my use of title, qualification, membership, or
other words or letters
 >> relevant to my area of health practice?
 >> current?
 >> verifiable?
 >> credible?
if I display or promote my qualifications in advertising materials,
is it easy to understand?
Is there any risk of people misunderstanding or misinterpreting
the words, letters or titles that I use?

71. Advertising of price information


Information in advertising of regulated health services
about the price of procedures must be clear and not
misleading.
Practitioners or other persons who advertise services:
 must not use phrases like „as low as‟ or „lowest
prices‟, or similar words or phrases when advertising
fees for services, prices for products or price
information, or stating an installment amount without
stating the total cost should not compensate or give
anything of value to a representative of the press, radio,
television or other communication medium for
professional publicity unless the fact of compensation is
made known publicly
 must not advertise time-limited and special offers.

72. Use of gifts or discounts in advertising
The use of gifts or discounts in advertising is
inappropriate, due to the potential for such inducements to
encourage the unnecessary use of regulated health services.
 If a practitioner or a person advertising a regulated health
service does use a discount, gift or any other inducement to
attract patients or clients to a service, the offer must be truthful,
and the terms and conditions of that offer must be set out
clearly in the advertisement.
 Discounts, gifts or other inducements must not be used in
advertising of medicines that have potential for abuse or
misuse due to the greater potential for harm.
 In relation to other medicines and therapeutic goods, the
boards strongly discourage the use of prizes, bonuses, bulk
purchases or other endorsements that may encourage the
unnecessary consumption of medicines or other therapeutic
goods.


73. Use of scientific information in advertising


Urge caution when using scientific information in
advertising of regulated health services.
When a practitioner chooses to use scientific
information in advertising, it should:
 be presented in a manner that is accurate,
balanced and not misleading
 use terminology that is understood readily by the
audience to whom it is directed
 identify clearly the relevant researchers, sponsors
and the academic publication in which the results
appear
 be from a reputable and verifiable source.

74. Advertising of therapeutic goods





Under the Therapeutic Goods Advertising Code 2007:
• there are general prohibitions on advertisements for
therapeutic products that
 >> appeal to fear
 >> are misleading
 >> raise unrealistic expectation on claims to efficacy
 >> claim to have miraculous properties, etc
• advertising must not be directed to minors, with certain exceptions
(e.g. sunscreen and condoms)
• representations about abortifacient action, neoplastic disease
(except in relation to the use of sunscreens), sexually transmitted
diseases (except in relation to contraceptive devices), HIV/AIDS or
mental illness are prohibited
• approval must be obtained from the Therapeutic Goods
Administration to advertise therapeutic goods for „serious diseases‟
that are listed in the Code.

75. Advertising of therapeutic goods
Advertisements must contain:
 • the trade name of the product
 • a reference to its permitted indications only
 • (where applicable) a list of the ingredients
 • the following statements prominently displayed
 >> always read the label
 >> use only as directed
 >> if symptoms persist, see your doctor/health care
professional.
Advertising of scheduled medicines
 Almost all State and Territory drugs and poisons laws prohibit the
advertising to the public of substances in Schedule 4 (prescription
only medicines), Schedule 8 (controlled drugs) and Schedule 9
(prohibited substances) of the current Poisons Standard (the
Standard for Uniform Scheduling of Drugs and Poisons).

76. Consequences of breach of advertising
requirements
Remind all practitioners of their legal and ethical
responsibilities in providing the public with clear and accurate
information about the availability of health services.
 Practitioners are reminded that members of the public have
limited understanding of many aspects of these services and
thus vulnerable.
 An advertisement is deemed misleading, when it creates an
unreasonable expectation of beneficial treatment, or
encourages (directly or indirectly) the indiscriminate or
unnecessary use of regulated health services or medicines,
 Most medical boards consider the overall impression of
advertisement and likely impact the advertisement have on a
member of the public.


77. Consequences of breach of advertising
requirements
Specifically, a national board will consider what conclusions the
public can reasonably infer from material contained within an
advertisement and if the material is likely to mislead or deceive,
(in)directly or by omission.
 Qualifiers or disclaimers should be displayed obviously rather
than contained in fine print.
 National boards cannot give legal advice or opinion, and cannot
„vet‟ or pre-approve advertisements for compliance with these
guidelines.
 If a person is in doubt about whether his or her advertisement
might be in breach of the Law, that person should seek his or
her own advice (e.g. from professional indemnity insurers or
lawyers) before placing the advertisement (In Malaysia, this will
be the LembagaIklanUbat [LIU], or Medical Advertisement
Board)


78. Failure to adhere to the guidelines
Failure to adhere to the guidelines may be
investigated by a national board (either in
response to a notification or on its own motion).
 A breach of the guidelines may constitute
unprofessional conduct and/or professional
misconduct, and as such, may be dealt with by the
boards through the disciplinary mechanisms
available under the National Law.


79. Failure to adhere to the guidelines

When a practitioner is found to have engaged in unprofessional
conduct and/or professional misconduct in relation to advertising
of regulated health services, the determinations that may
include, but are not limited to, one or more of the following:
 • requiring the practitioner to undergo counselling
 • cautioning the practitioner
 • reprimanding the practitioner
 • requiring the practitioner to undertake further education
 • imposing conditions on the registration of the
practitioner (e.g. requiring the practitioner to publish a
retraction or correction)
 • imposing a fine on the practitioner
 • suspending or cancelling the practitioner’s registration.

80. ADVERTISING OF MEDICAL SERVICES

Provision of information about doctors and the services they
provide is recognised as being of value to the public. For
example, patients need information when choosing a general
practitioner and deciding how best to utilise their services.

General practitioners need information on specialists to
provide proper advice to patients and make appropriate
medical referrals.

On the other hand, both patients and doctors can be
particularly susceptible to persuasive influence and are
entitled to appropriate protection from misleading or false
advertisements.

81. ADVERTISING OF MEDICAL SERVICES

Australian competition law prohibits professional
organisations from restraining advertising such that is
likely to lessen competition. It also prohibits advertising
that is false, misleading or deceptive or that which is
likely to mislead or deceive.

The AMA does not condone advertising that tends to
bring the profession into disrepute.

This stand is supported by some State and Territory laws
and local Medical Boards that place restrictions on
advertising that compromises the dignity or decorum of
the profession.

82. The Australian Medical Association position
The AMA Code of Ethics (2004) (revised November 2006) (at 2.2) sets out the
standards of ethical advertising expected of medical practitioners
1. Confine advertising to the presentation of information reasonably needed by
patients or colleagues to make an informed decision about medical services,
2. Ensure the advertisement is demonstrably true in all respects and
3. Ensure that it should not bring the profession into disrepute.
4. It also directs that there should be no endorsement of therapeutic goods
contrary to the Therapeutic GoodsAdvertising Code, and recommends caution
in endorsing any commercial product not covered by that code.
Further information is available at the AMA website (www.ama.com.au).

83. Medical Boards Guidelines…



The Medical Board of South Australia has published
guidelines for the advertising of medical services.
The guidelines specify:
 The appointment of a registered medical practitioner
who is to be responsible for the advertising of
medical services
 The appointment is to be notified to the Board
 The notified medical practitioner is to be responsible
for any breach of the advertising guidelines
Electronic advertising (television, radio, internet etc.)
is not permitted unless the advertisement includes a
good health or preventable health message and the
advertisement does not imply that the medical services
provider is the only provider of the medical service
www.medicalboardsa.asn.au

84. 


Physicians who use online media, such as social
networks, blogs, and video sites, should be aware of the
potential to blur social and professional boundaries.
They therefore must be careful to extend standards for
maintaining professional relationships and confidentiality
from the clinic to the online setting.
Physicians must remain cognizant of the privacy
settings for secure messaging and recording of patient–
physician interactions as well as online networks and
media and should maintain a professional demeanor in
accounts that could be viewed by patients or the public.

85. Medical Boards Guidelines…



Acceptable content for advertising includes the
name, qualifications, contact details, practice
hours, availability of after-hours services,
languages spoken, billing method, wheelchair
access and specialist qualifications and fields
of practice (as recognised by the Board)
Unacceptable content includes anything which is
false, misleading, deceptive, vulgar or sensational,
includes claims of superiority or criticism of other
doctors, contains testimonials, includes the use of
identifiable patients or which might be likely to
bring the profession into disrepute
Records of advertising are required to be kept for
three years.
www.medicalboardsa.asn.au

86. Generally speaking,
advertising is permitted,
provided:
It is not misleading or deceptive
 It is true and verifiable
 It does not create an unjustified
expectation of beneficial treatment
 It does not use testimonials from patients
 It does not involve claims of superiority or
criticism of other colleagues
 It does not promote unnecessary and
inappropriate use of medical services.

In October 2008, the Medical Practitioner Board of Victoria published extensive guidelines for
advertising. These are available at www.medicalboardvic.org.au.

87. Principles of Prudent Resource Allocation:
1. As a physician performs his or her primary role as a patient‟s trusted
advocate, he or she has a responsibility to use all health-related
resources in a technically appropriate and efficient manner.
2. He or she should plan work-ups carefully and avoid unnecessary
testing, medications, surgery, and consultations.
3. Resource allocation decisions are most appropriately made at the
policy level rather than entirely in the context of an individual
patient–physician encounter. Ethical allocation policy is best
achieved when all affected parties discuss what resources
exist, to what extent they are limited, what costs attach to various
benefits, and how to equitably balance all these factors.
4. Physicians, patient advocates, insurers, and payers should
participate together in decisions at the policy level; should
emphasize the value of health to society; should promote justice
in the health care system; and should base allocations on
medical need, efficacy, cost-effectiveness, and proper
distribution of benefits and burdens in society.

88. “Medicine, law and social
values are not static…”

89. Definition of medical profession

91. “Medicine, law and social
values are not static…”
Should we not seriously consider amending our advertising
(medical information dissemination), our code of conduct and
regulations to address these changes in perceptions and
social values of this day and age?

92. Thank You…