Often hospitals are reluctant to make a stink about an ad they don't like because they don't want to come across as defensive or draw attention to the issue.
The American Hospital Association has issued guidelines on advertising that declare content should be "measured primarily by its truthfulness, fairness, accuracy, completeness and sensitivity to the healthcare needs of the public."
The guidelines have been adopted by many state hospital associations. They're meant to address ads that are not technically false and therefore not subject to action by the Federal Trade Commission or state consumer protection departments.
But the association guidelines are seldom enforced.
"We're not set up to discipline members. I don't think any state association or regional association or the AHA is," said Wade Edwards, vice president of public relations of the Florida Hospital Association.
The Florida association hasn't received any complaints about hospital advertising in at least five years, Edwards said. "Some hospitals might be upset with each other, but they don't come to us with it," he said.
One hospital that did bring its beef to a local association was St. Tammany Parish Hospital in Covington, La., 37 miles north of New Orleans.
Steve Soteropulos, the planning and marketing director at St. Tammany, said the town's two hospitals long engaged in image-based advertising campaigns designed to increase their name recognition.
But the tone changed in 1995, he said, when rival Highland Park Medical Center was acquired by Columbia and undertook an aggressive ad campaign. In one newspaper ad in July 1995, the newly named Columbia Lakeview Regional Medical Center compared its cardiac services with those offered by St. Tammany.
Using data from the Metropolitan Hospital Council of New Orleans, Columbia Lakeview said it performed more inpatient and outpatient cardiac catheterization procedures, treated more cardiac rehabilitation cases and did more open-heart surgeries.
"There was a tremendous uproar with our staff and physicians. We were never faced with a negative advertising campaign," Soteropulos said. "And they asked me what I was going to do about it."
Rather than hit back with similar advertising, which Soteropulos said could tarnish the hospital's image, St. Tammany ratted on Columbia Lakeview to the hospital council, whose rules restrict hospitals from releasing data on other hospitals.
Council President John Finn attributed Columbia Lakeview's error to executive turnover. He said he met with the chief executive officer of Columbia Lakeview, James Rogers, who agreed to stop the practice after the advertising contract with the newspaper had been fulfilled. The ads ran twice more, with the addition of a line citing the source of the data. Finn also sent a reminder to local CEOs about the restrictions on using the council's data.
Soteropulos said he was satisfied with the council's effort but disappointed that the ad continued to run.
"We would have liked to see the ad discontinued immediately, but that was not the case. It just compounded our frustration," he said.
Rogers defended the ad and the hospital's advertising campaign, which he said began before Columbia purchased the hospital and has nothing to do with the Nashville, Tenn.-based hospital chain.
"Our ads are extremely professional and don't say anything negative about anyone," Rogers said. "It's just that this has never been done here, and it caught people by surprise."
He also attributed St. Tammany's reaction to sour grapes and the fact that it's losing market share to Columbia Lakeview.
But, Rogers admits he got his "toe in a ringer" over the cardiac services ad, claiming that no one ever told him he was not supposed to use the council's data in comparative advertising.
"We pulled the ad after the cycle and never placed it again," Rogers said.