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MARKETING OBSTETRIC CARE

Marketing has a strong influence on obstetric services today. Many hospitals offer special facilities and services to compete for the lucrative market in delivering well-insured obstetrics patients. This is seen as a particularly attractive market because of the many ancillary services to be sold to affluent patients. These marketing strategies have varying impacts on patients' medical care. Providing comfortable waiting rooms or champagne for the family may attract patients, but it does not ensure quality medical care. Offering birthing rooms and one-day discharge can be beneficial to the patient but requires changing the practice habits of obstetricians and pediatricians.

Marketing obstetrics services becomes a legal problem when it reinforces the illusion that childbirth is a risk-free, enjoyable experience. Advertisements with pictures of healthy babies and smiling mothers may be accurate for most deliveries but not for all. For those who are not so lucky, those advertisements fuel the resentment and bitterness that lead to medical malpractice lawsuits. Obstetricians should be especially careful about associating with physician referral services that are coupled with public advertisements. These referral services often make explicit and implicit promises about the physician services, promises that can complicate the physician-patient relationship.

Both physicians and hospitals should be careful that their advertisements do not constitute a guarantee that patients will be delivered in whatever way they wish. The special facilities may not be available if there is a clustering of births on one day. In some cases, birthing chairs or natural childbirth may not be appropriate for a given patient. An obstetrician should know what the hospital offers and what his or her patients want. If the hospital has special programs that the physician does not participate in, every patient should be told of the nonparticipation. These matters must be addressed in the first prenatal visit. Seven months into the pregnancy is too late to find out that the patient has reserved the birthing room and the physician will not use it. This will anger the patient and could raise the issue of consumer fraud if the hospital's advertisements promise services that are not available.

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