Ethics and the Advertising of Professional Services: Blame Canada

Canadian Psychology, May 2004 by Koocher, Gerald P

Abstract

Shead and Dobson (this issue) provide an excellent historical review of policies concerning self-advertising by psychologists in the United States and Canada. They conclude that psychologists can become considerably more aggressive in their professional advertising practices, while still adhering to appropriate ethical constraints. Whether such practices will truly benefit either consumers or psychologists remains an open question.

Times have changed, our kids are getting worse They won't obey their parents, they just want to fart and curse

Should we blame the government? Or blame society?

Or should we blame the images on TV?

No, blame Canada, blame Canada!

We must blame them and cause a fuss

Before someone thinks of blaming us!

-South Park: Bigger, Longer & Uncut Finding ways to distinguish oneself and one's services from competitors in the marketplace has a history as old as commerce itself. Professions have long sought with varying degrees of success to self-regulate with the stated goal of public protection or quality enhancement. From the consumer's perspective, such efforts by professional guilds often served only to limit choice by controlling entry into the professions, speciiying accepted modes of professional service delivery, limiting access to practitioners, and thereby affecting pricing. Modern Western society has increasingly become consumer focused, relying on the pervasive dictum of caveat emptor (i.e., let the buyer beware). Wc have come to believe that wary consumers can generally review their options and make informed marketplace decisions on their own. Civil libertarians and more protectionist government leaders constantly philosophize contentiously over the comparative merits of commercial deregulation versus increased consumer protections.

Should the buyer alone he responsible for assessing the quality of a potential purchase? Should the government set protective regulations assuring minimum safety or quality in some product or service domains? Should public authorities cede rule-making or regulatory authority to trade groups or professions? Some commentators in psychology and other professions presume that increased tolerance for advertising of professional services will aid the public in locating services and result in lower prices because of increased competition. Others argue that more pervasive advertising of professional services will only confuse people, lead to hucksterism, and actually increase costs in the long run as practitioners build advertising costs into the fees they must charge to earn a living. At present, we have inadequate data to answer these questions. Shead and Dobson (this issue) provide a well-integrated overview of arguments that have been advanced regarding advertising by psychologists in both Canada and the United States. They effectively capture the core conflict for psychologists. We train fundamentally as behavioural scientists, so a natural tension arises when we try to tell the public about ourselves. The vast majority of potential consumers do not want to hear detailed discussions of controlled studies, accounts of how individual human differences can lead to variation in outcomes, or comparative analyses of different theoretical approaches. The public will generally not understand the scientific qualifiers we may want to place on our work. They simply want prompt, effective, and affordable help from a confident practitioner who will promise to help them. After all, they are daily bombarded with offers for products that assure significant weight loss with no change in diet or exercise regimen, and political commercials suggesting that a sound bite or two constitutes the ideal basis for choosing a national leader. Why should the public expect or want more rigorous data to use in selecting a psychologist?

Potential consumers of psychological or other professional services are apt to seek advice from trusted sources (i.e., friends, relatives, or other professionals). Sometimes such guidance has little practical value. The psychotherapist who was so helpful to recently widowed Aunt Matilda, may lack the experience, empathy, or rapport-building skills needed to help 15-year-old cousin Billy whose acting out and alcohol problems have gotten him in trouble at school and with the juvenile court. Little or no evidence exists to suggest that professionals perform more effectively than friends and relatives in making referrals. The one exception may occur when a professional suggests a referral based on matching the known expertise of the psychologist with the stated need of the client. For example, when asked for a referral for a person with recent onset of panic attacks, I tell them about the local university's centre for the treatment on anxiety disorders. 1 have read publications by some of the faculty there and have seen the three-colour brochure they sent to me. Is this wisely informed professional judgment, or simply my response to another type of advertising? After all, I do not truly know whether the people who published the research will play any role in the client's treatment or even whether they have therapeutic skills, as opposed to research talent.