As the world grappled with the aftermath of September 11, the cosmetic surgery industry in Australia was quick to recognise a marketing opportunity.
Collagen Australia, whose parent company is the US-based Inamed Corp, issued a news release late last year claiming that business was booming for cosmetic surgeons in the wake of the disaster. The release began memorably: “Once, when a woman was down in the dumps, she bought a hat. More recently, she went out and bought a bright lipstick. These days, however, when economic times are tough and the future uncertain and she wants to cheer herself up, she plumps up her lips or has her wrinkles removed.”
A cosmetic plastic surgeon was quoted as saying that many patients had put overseas holidays on hold because they were concerned about air travel and were choosing to have cosmetic surgery instead of a holiday. “People are saying they want procedures and treatments to cheer themselves up, make them feel better,” he said. “They are saying we don't know what is around the corner, so let's enjoy life now.”
While some might see this as a blatant attempt to promote both product and professional services, many media outlets saw it as news. The release was widely covered by radio and newspaper outlets, according to Pamela Robson, the public relations practitioner who circulated it on behalf of the manufacturer.
Collagen Australia says it was pleased with the coverage. This suggests media reports did not raise issues such as the appropriateness of using September 11 as a marketing tool, or whether equating cosmetic procedures with a holiday does justice to the potential risks of the former.
Robson, whose consultancy specialises in medical marketing, says the public generally does not appreciate that when doctors are quoted in the media, it is often because they are actively promoting something. “They are all very keen to be in the media and they are very keen on publicity because publicity gives you the kind of credibility you don't get from an ad,” she says.
While this news release is extreme in some ways, not least because of its patronising depiction of women, it highlights a broader issue: that a convergence of professional, commercial, and media interests can lead to promotional media coverage which often has the effect of medicalising issues.
Medicalisation is not only in the interests of health professionals and manufacturers; it also suits the media imperative of attracting audiences. New treatments and research which promises to provide new treatments thus generally rate high on the scale of newsworthiness.
Much coverage of diagnostic and screening tests—which have the potential to lead to a cascade of medical intervention—is also promotional, highlighting benefits rather than risks and costs.
Similarly, the media has been quick to promote the potential benefits of functional food, or “food as medicine,” and of genomics, as reflected in reports heralding the development of widespread genetic screening and intervention.
Another way that the media contributes to medicalisation is by giving greatest prominence to the views of doctors when covering health, while consumer viewpoints generally are under-reported. We often are surprisingly uncritical of medical sources, and rarely, for example, ask doctors and researchers if they have potential conflicts of interest.
If a doctor says something—that cosmetic surgeons are busy because of September 11, for example—it must be true. An alternative explanation—that business is booming because of effective marketing—is not raised.
Hilda Bastian, convenor of the Cochrane Collaboration's consumer network, says the media's amplification of public health messages has also contributed to medicalisation, by raising public concerns about risk. “Public health experts are making us all paranoid, that at any time your body could be turning against you,” she says. “Here we are, healthier than we've ever been if you're in a developed country, and yet people are more scared than they've ever been about illness.”
Bastian says competition between charities and other groups for public awareness and funds also helps promote public concern about health. “Any survey will show that people totally overestimate their risk of cancer,” she says. “Does that stop cancer awareness-raising activities? It does not. How scared do you have to be? The answer is, till their area is as well funded as they want it to be.”
There may be some truth to the old joke that medical journalists make a living out of encouraging hypochondria and public alarm. What's good news for media business can also be good news for medical business.
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USGS/AP PHOTO
September 11: used as a marketing tool