Services of Medical Practitioners
A report on the supply of the services of registered medical practitioners in relation to restrictions on advertising.

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Summary

We were asked to investigate and report on the advertising restrictions observed by registered medical practitioners and their effect on the public interest.

We were primarily concerned with the guidance of the General Medical Council (GMC), the statutory regulatory body for medical practitioners. Its guidance on the standards of professional conduct includes advice that doctors should not engage in promotional advertising. We also examined the guidance that the British Medical Association (BMA) and the Royal College of General Practitioners (RCGP) issue to their members.

Our inquiry covered two separate groups of doctors: first, specialists in private practice and secondly, all general practitioners, whether they practise privately or within the National Health Service (NHS). We included within the second group those practitioners offering complementary or alternative therapies. The circumstances of the two groups were different so that we found
it necessary to consider separately the effects of the restrictions on those two groups. Throughout, our inquiry was influenced by the overriding importance of the NHS in the provision of medical services in the United Kingdom.

We find that observance of the guidance of both the GMC and the BMA governing advertising by specialists to members of the public does not operate against the public interest, except in so far as it prevents associations of specialists from responding to direct requests for information from members of the public.

We find that observance of the GMC guidance (in the version currently circulated to members) and the similar BMA guidance restricting advertising by specialists to other doctors, operates against the public interest. During our inquiry the GMC amended its guidance to allow specialists to contact their colleagues as they see fit. We consider that these changes remove the adverse
effects of this part of the GMC guidance.

We note that during the inquiry the GMC relaxed, but did not entirely remove, restrictions on the ability of doctors or their professional associations to communicate with other bodies or professionals in circumstances where they are not offering medical treatment to patients. We find observance of the remaining restrictions on such contacts imposed by the GMC and BMA
operates against the public interest.

We find that observance of those parts of the GMC and BMA guidance which restrict advertising by general practitioners to members of the public operates against the public interest. We also find that one part of the guidance offered by the RCGP, namely that general practitioners should ensure that their practice leaflets are acceptable to local colleagues, operates against the public
interest.

We invite the GMC, the BMA and the RCGP to revise their guidance to remedy the various adverse effects identified above.

We consider that the CMC and BMA guidance should be revised to permit advertising by general practitioners subject to the two broad principles that such advertising:

(a) should not be of a character that could reasonably be regarded as likely to bring the profession into disrepute; and

(b) should not be such as to abuse the trust of patients or exploit their lack of knowledge.

We indicate some provisions that would reflect these principles in today's circumstances and could therefore properly be included in the guidelines:

(a) that the content of advertisements should be limited to factual information, should be legal, decent, honest and truthful, and should not disparage other doctors or make claims of superiority;

(b) that no advertisements should include explicit or implicit claims to cure particular complaints;

and

(c) that general practitioners should not use 'cold calling' or other means of trying to target individual members of the public, and should not advertise so frequently as to cause a nuisance to potential patients or put them under pressure.

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