Do you enjoy the commercials on television by the drug companies for particular drugs?

It is almost comical how the drug company will spend a few seconds highlighting the benefits of the drug, and then the rest of the commercial is spent telling you about all of the side effects and contraindications of the drug. Pharmaceutical companies spend billions promoting drugs to doctors and consumers.

A New York University study from 2008 indicates that big pharma spends twice as much money on promotion of drugs as is spent on research and development. A study in a British medical journal from 2012 says that the ratio is 19 to 1. All we have to do is turn on the television to see how pervasive drug marketing has become.

Clever marketing has also infected the advertising of hospitals and doctors.

One hospital affiliated with a university which has a mythical bird as its mascot, uses famous Hollywood actors to explain how it is on the cutting edge of research and medical treatment. It is a fine hospital and undoubtedly one of the best in the Kansas City area, but it does spend a lot of money on advertising. The competition for patients can be fierce and doctors and hospitals have been forced to hire clever advertising firms to help them attract new patients.

Some doctors have been outspoken in their opposition to these marketing tactics, especially with regard to new “cutting edge” surgical techniques. For example, a well-respected physician at one of the leading hospitals in the United States, Johns Hopkins Medical Center, has been outspoken about the advertising that many hospitals have done for robotic surgery.

In a 2011 study in the Journal for Healthcare Quality, the researchers undertook to examine the prevalence and content of robotic surgery information on websites of 400 hospitals.

The authors of this article reported some interesting findings. They found that 37 percent of the hospitals surveyed had information on the home page of their website touting the benefits of robotic surgery at the hospital. A statement of clinical superiority was made on 86 percent of the websites. They found that not one hospital mentioned the risks of robotic surgery.

The authors concluded that hospitals were overestimating the benefits of the robot and largely ignoring the risks. And to no one's surprise, the authors also found that the materials used in marketing robotic surgery were provided by the manufacturer.

The authors suggest that more oversight is needed to ensure the information provided on hospital websites is accurate and that the hospitals should be conscientious of their role as a trusted medical adviser and present the best medical evidence on the risks and benefits of the procedure. The authors also suggest that the hospitals should make it apparent that the manufacturer's products are being shown.

The authors also concluded that if the hospitals are unable to provide patient-friendly objective information about a particular treatment option, it should direct patients to a third party source of information.

Oversight is needed according to this study and it suggested that the Food and Drug Administration be the oversight agency. The bottom line of the study is that patients should make decisions on healthcare with balanced information based on evidence. It is unlikely that the FDA will become involved in overseeing marketing efforts by hospitals. The hospitals have a very strong lobby in the federal and state capitols. Thus, they will resist any oversight of marketing efforts. Thus, don't count on government to protect you.

In the absence of balanced information based on evidence, the patient must become his or own investigator. It is acceptable to ask the surgeon many questions before consenting to robotic surgery. The surgeon's experience is critical and the complication rate should be determined.

No doctor is perfect, but the more experience a doctor has, the better he or she is going to be at a particular procedure. One thing you should not do is rely on fancy advertisements. They are going to try and hit your heartstrings with powerful marketing tools. Don't be fooled by the rhetoric. I doubt you will see Joan Allen or Tom Skerritt roaming the halls of that medical center unless they are filming a new commercial.

Patients have rights, so exercise them and ask questions. Your doctor might be irritated by your questions, but his or her experience or lack of experience should be an important factor in the health care decision. I had a client who was convinced by his doctor to undergo a new “cutting edge” hip replacement surgery by his doctor.

The doctor failed to inform him that he had only performed this cutting edge procedure on a handful of patients other than a cadaver, and that he only learned how to do the procedure five months earlier. Had my client known that, he would have run out of his office on his arthritic hip. He wishes he had asked more questions.

So, ask questions and if the doctor is offended or evasive, find another doctor. Do not make healthcare decisions on the quality of advertisements.

Bob Buckley is an attorney in Independence. Email him at