SINGAPORE: Discounts, freebies, celebrity endorsements — you see them everywhere in advertisements daily — but they have landed at least 60 healthcare institutions in the soup since 2004.

That was the year the Private Hospitals and Medical Clinics Act — first established in 1997 — was amended to allow advertisements of health services in newspapers, other publications and on the Internet.

According to the Ministry of Health (MOH), there have been 15 to 20 cases annually of "contraventions committed by healthcare institutions aimed at soliciting and encouraging the use of services provided by or at the healthcare institution". These include offering special prices, discounts and free gifts, making laudatory claims, using celebrity personalities and using patient testimonials, an MOH spokesperson said in a reply to TODAY's queries.

Recently, Lasik clinics appeared on the ministry's radar for giving public "unrealistic expectations" of what the vision-correction procedure can do, to quote a letter the MOH sent to ophthalmologists. Apparently, results are overstated while risks and possible side-effects are downplayed. Some advertisements also cite success rates that are not from the clinics.

TODAY also understands that there have been concerns over another area: Treatments that are being touted by general practitioners and specialists but whose effectiveness have yet to be proven scientifically — such as whitening injections and mesotherapy.

The current advertising guidelines allow health service providers greater leeway in advertising their products. Instead of prescriptive "dos and don'ts", the MOH revised the guidelines to comprise "broad principles for compliance" and allowing healthcare institutions to publicise services through third party channels like interviews and editorial write-ups.

These regulations oversee the publicity of services by healthcare institutions licensed under the Act. However, they do not govern individual doctors who have to comply with the Singapore Medical Council's Ethical Codes and Guidelines regarding publicity.
Although the publicity regulations were made more liberal in 2004, the primary objective remained the same, said the MOH spokesperson — "to allow healthcare institutions to provide information about their services so the public can make informed choices".
Since the advertising guidelines have been relaxed, the response has been buoyant especially among professionals in aesthetic treatments.

Lecturer Ms Isabel Chew first read about mesotherapy – an injection of a medicine, vitamins and plant extract cocktail to the layer of fat just below the skin to help one get rid of fat – on an online advertisement posted on a local doctor's website. Enticed by its potential, she decided to give the treatment a go.

"I was having water retention problems and decided to try it out," said the 31-year-old. "I didn't find it that effective." Still, Ms Chew did lose 3.5kg over a weekend without any adverse effects – although she did note that she was also taking diet pills and had modified her lifestyle.

But while the spotlight may have been on doctors who oversell, many of the health service providers who are bound by the Act are actually concerned that they are not allowed to sell themselves well enough.

Occupational medicine specialist in private practice Associate Professor Michael Ong said: "From the medical point of view, people are still very conservative when it comes to advertising." So, while an advertisement with special discounts and celebrity endorsements may be nothing out of the ordinary for consumers, the medical industry still frowns upon such advertising tactics within its own ranks.

Dr Ong is the medical director of Hyperbaric Medical Services, which offers oxygen chamber treatment. The clinic places advertisements in various print media.

"We stick to MOH-approved indications as to what the chambers can be used for; these have to be evidence-based indications such as the treatment of diabetes," he explained. "Although they have been used for other purposes like beauty, there's no evidence to back the claims, so we don't advertise for those."

In addition, pervasive peer pressure in the medical profession helps to keep advertisers in check. - TODAY/ar