Jos VM Welie, Melissa Simpson
& Gary H Westerman*
Creighton University Center for Health Policy and Ethics, Omaha, US
The Troubled History of Dental
Advertising
Part 2: Historical Notes
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The Early Years Advertising is an old custom among dentists. We can still savor the advertisements from our illustrious predecessors from the 17th and 18th. Wandering from town to town, these itinerant dentists had to announce their arrival with a lot of pomp and circumstance. Indeed, dental care was itself a show, performed on the market square for the enjoyment of the bystanders. The extravaganza of some of the advertisements from those days can be gleaned from this critical outcry: "There are always a set of imposters, or would-be dentists, who have recourse printer’s ink (the devil of course has something to do with it) to bring themselves into notice; ... unfortunately for the people, their flaming advertisements inveigle persons who are not educated to a proper appreciation of dental operations until, alas !! too late." (Vandevort 1863, p. 71) The Profession of Dentistry In the mid-19th century dentistry became an academic discipline. Or more correctly, a new class of academically trained dentists arose who had to compete with barbers, blacksmiths and the itinerant quacks. United into professional associations, one of the strategies used by the academics was to prohibit advertising. After all, advertising was associated with itinerant sales-men and quacks who were trying to sell their dental services. |
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For example, the 1866 ADA Code of Ethics deemed it
unprofessional to resort to public advertisements, cards, handbills,
posters, or signs, calling attention to peculiar styles of work, lowness
of prices, special modes of operating, or to claim superiority over
neighboring practitio-ners, to publish reports of cases or certificates
in public prints, to go from house to house to solicit or perform
operations, to circulate or recommend nostrums, or to perform any other
similar acts. Nevertheless, advertising continued to be a problem, judging by the ever more lengthy sections on this matter in the ADA Code. In 1924, eight more specific restrictions were added. Included were claims about one’s ability to perform services in a superior manner, special methods of practice, and giving guarantees. Nothing, however, could curb advertising virtuosos such as Edgar Randolph "Painless" Parker (1872-1952), whose advertising stunts have become legendary. (Those interested in learning about Painless Parker may want to read his 1995 biography by Christen & Pronych). In 1920 Parker blamed his opponents - cynically called "ethicals" - for being outdated. (Curtis 1995) None of his outraged critics could foresee history would one day vindicate him. But that would take another 60 years. As late as 1962, the ADA’s Principles of Ethics insisted that the dentist has the obligation of advancing a reputation for fidelity, judgement and skill, solely through professional services to patients and to society. The use of advertising in any form to solicit patients is inconsistent with this obligation. Advertising was – and is – indicative of competition and creates needs where there may be none. For these reasons, most dental ethics codes prohibited and – outside of the US – still prohibit advertising.
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The Big Change But in the 1970's the courts in the United States began to view prohibitions on advertising by professional associations as restraints on competition, rather than restraints on unprofessional solicitations. The first profession forced to lift its ban on advertising was the legal profession. In 1975 the US Supreme Court rejected the notion that certain professions were exempt from antitrust laws and began applying antitrust laws to activities of professional associations in Goldfarb v. Virginia State Bar. Subsequently, the US Federal Trade Commission (FTC), seeking to eliminate practices that interfere with free competition, began interpreting all professional prohibitions against advertising as forms of unfair monopolization. Two years after the decision in Goldfarb, the FTC alleged that the American Medical Association (AMA) was restraining its members from engaging in competitive practices through its code of ethics. An administrative judge reviewed the case in a trial-type proceeding and sided with the FTC, as did the US Court of Appeals. In 1982 the case finally reached the US Supreme Court, which denied the AMA's petition for review, thereby upholding the decision of the US Court of Appeals’ decision in favor of the FTC. Conse-quently, the AMA, the ADA and other professional health care organizations were forced to lift their ban of advertising (except for advertising that is false or mis-leading in any material respect). A new chapter in the history of dental advertising had begun. |
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References Christen, A.G. and P. M. Pronych: 1995, Painless Parker. A Dental Renegade's Fight to Make Advertising "Ethical". Baltimore: National Museum of Dentistry. Curtis, E.K.: 1995, 'Bombastic Ballyhoo: The Extraordinary Advertising Life of Painless Parker',J.Am.Coll.Dent. 62(3), 55-57. Goldfarb v. Virginia State Bar,421 U.S. 773 (1975) Vandevort, J.W.: 1863, 'Quack Advertisements',The Dental Times I(2), 70-72.
Acknowledgement This is the second article in a series of four that was originally prepared for the newsletter of the Nebraska Dental Association. It is reprinted, with minor revisions, with the permission of the NDA. * All three authors are affiliated with Creighton University. Jos VM Welie, MMedS, JD, PhD is an Associate Professor at the Center for Health Policy and Ethics and the Department of Community and Preventive Medicine. Melissa Simpson, JD, recently graduated from Creighton University School of Law and was a Research Assistant at the Center for Health Policy and Ethics. Gary H Westerman, DDS, MS, holds the Dr. Oscar S. Belzer Endowed Chair and is Professor and Chairman of the Department of Community and Preventive Dentistry, as well as a Faculty Associate at the Center for Health Policy and Ethics.
Contact address: Dr. Jos VM Welie |
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