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 informal settings 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.