Applied Radiology

Dr. Mirvis is the Editor-in-Chief of this journal and a Professor of Radiology, Diagnostic Imaging Department, University of Maryland School of Medicine, Baltimore, MD.

About 20 years ago, I was sitting at a meeting with senior staff members (I have no idea what I was doing there). The CEO was wondering why our inner-city hospital was unable to attract the nice suburban patients who generally had private insurance. “We do so many great things here. Why won’t they come?” We speculated about the lack of parking, the long drive downtown, fear of the neighborhood around the hospital, and competition from a certain other major hospital in town. Same old stuff; nothing we all didn’t know.

Since my father sold radio advertising and I knew something about that and its potential power, I suggested we do some radio and newspaper ads to improve how we were perceived and what great care we provided. The CEO, who I really admired, looked at me as if I had a screw loose. I get a lot of that. He laughed about how a professional organization like a hospital would look sleazy actually advertising our services. I argued that lawyers were advertising all over the place – by the way, I believe this development made lawsuits a growth industry and was the start of the downfall of the United States as a world power. The fact that lawyers did it only stiffened the CEO’s resolve not to.

Flash forward to today. Medical facilities advertise like crazy. Driving to work in the morning (23 minutes) I hear at least 5 commercials for medical services. They are mildly to markedly sickening. Blah, blah, blah has the best fertility success rate in the area – the “area” is a one-block radius around the clinic. The Jones family 2 blocks away has a much higher fertility success rate. Blah...also has a payment plan to meet anyone’s reproductive needs. If you really want to save money, blah offers lower cost, alternative treatments (I can only imagine).Another allegedly top-tier facility talks about their brand new gamma-knife that eliminates target tumors and spares surrounding tissue. The fact that this is about the twentieth gamma-knife in the Metro D.C. area is beside the point. The benign effects of this treatment are grossly overemphasized. As a final example, we have the Lasik specialist offering a deep discount for the first 500 patients to sign on, but they must have both eyes done. I guess that means whether the other eye needs correction or not.

Well, since we have all clearly sold out to the Madison Avenue Men, we might as well go all the way. I propose a “buy one get one free”offer on any imaging test you want/need. We could do His and Her barium enemas or prenuptial couples total body CTs to see if any problems may be secretly lurking in the background that could haunt one spouse later; a sort of high-tech kicking of the tires. Hospitals could offer credit cards with double points for surgery that can be redeemed for pharmaceuticals, lab tests or, in our hospital, a hyperbaric oxygen treatment. Another commercial trend I really like is putting food vendors in hospitals, particularly fast food joints. These are not only profitable today but provide future cardiovascular, liposuction, and gastric bypass patients for tomorrow. We now have a food court in our hospital that is a culinary wonderland (you wonder what things are). There is a store selling fancy wigs and all kinds of cosmetic paraphernalia to deal with hair or tissue loss and so on. The typical hospital sundries store in the lobby is totally bourgeois.

Again, we need to ramp this commercial arm of our institutions up. Why not have entire shopping malls attached? You have a captive audience of patients, their families and visitors, kind of like an airport. Every commercial on hospital TV would push shopping in our mall. We actually now have T-shirts you can buy that say: “I survived Shock-Trauma twice.” That’s a double; profit in the shirt and free advertising.How about another t-shirt with: “My hemorrhoids were treated at so and so rectal clinic”?

My colleague Dr. Shanmuganathan and I have plans to open a Sri Lankan and Jewish-style restaurant in our hospital called (Shan Grill-La) to supplement reimbursement cut-backs. Just imagine curried white fish on your choice of Nan bread or bagel. I guess the menu would need to be IRB approved. This would become an international chain and in no time an IPO would bring in a few billion dollars, and we could buy any imaging equipment we could dream of. We would really be the first in the area to have all the new toys.

These are only a few ideas to consider. I am sure the ad men can come up with hundreds more. Who needs to worry about Medicare or insurance company reimbursement? We could give discount or free care with impunity. The residents could have swimming pools, exercise rooms, a movie theatre, and BMW’s. So you see, I was right 20 years ago, just way ahead of my time. The retired CEO is now sitting at home watching the sizzling new hit TV series from our hospital—Darkroom Affairs—and wondering why he didn’t take me seriously.