It's a rough sport.

Abstract

Your business manager has repeatedly advised you to update your Web site. You have recently added a new associate to your practice, so you agree that a revision is indeed due. Although you accept that an orthodontic practice is both a profession and a business, your predominant strength and interest has always been in the delivery of the best clinical care that you can provide. But your Web-site designer and your business manager encourage you to become involved to give them an idea of your vision of your “Web-site look.” One Saturday morning after a hectic week, you pour yourself a cup of coffee and open your laptop. You decide to peruse the Web sites of your local competitors to gather some ideas of contemporary Web-site designs. As you begin your review, you nearly choke on your coffee. There's one orthodontic group that claims to be the best in the state—experts at treating overbites in record speed while adult patients are treated to a foot massage. Another lambasts early treatment of maxillary constriction, displaying images of children who have undergone nasal ridge depression caused by maxillary expansion that was claimed to be conducted improperly and unnecessarily. A third posts a lengthy, embellished resumé that depicts the orthodontist as an inventor and a superior clinician who calls herself a world-renowned lecturer on Class III treatment strategies. “What happened to professionalism and where went collegiality?” you ask yourself as you close your laptop in disappointment. In the late 1970s, the Federal Trade Commission (FTC) began a campaign to legalize advertising among the professions. The FTC is an independent governmental agency whose principal mission is consumer protection and promotion of competition.1Federal Trade Commission. Available at: www.ftc.gov/about-ftc/what-we-do. Accessed March 11, 2016.Google Scholar The FTC's objection to the ban on professional advertising was that this practice deprived the public of the benefit of free competition.2Competition in professional services in the United States. Available at: https://www.ftc.gov/sites/default/files/attachments/us-submissions-oecd-and-other-international-competition-fora/iberto-professional-services.pdf. Accessed April 4, 2016.Google Scholar Despite strong objections by the American Medical and Dental Associations, the FTC was ultimately successful in legalizing professional advertising. This included not only physicians and dentists, but also other professionals such as attorneys, accountants, and mental health providers. Before the change in the law, advertising had to be modest. Printed signage was to be no more than 8 inches in height and advertisements were limited to small boxes inserted in phone book listings. In 1979, legislation was passed that greatly expanded a professional's opportunity to advertise.2Competition in professional services in the United States. Available at: https://www.ftc.gov/sites/default/files/attachments/us-submissions-oecd-and-other-international-competition-fora/iberto-professional-services.pdf. Accessed April 4, 2016.Google Scholar Several forms of advertising have been described. Comparable advertising involves a statement of superiority and is unethical because it can be misleading. Examples include “best treatment of overbites in Michigan” or “only boarded orthodontist in Anytown, USA.” Competitive advertising involves free or discounted services to afford the advertiser an advantage over competitors. More services for the same price or reduced fees for the same service might be offered.3Graskemper J.P. Ethical advertising in dentistry.J Am Coll Dent. 2009; 76: 44-49PubMed Google Scholar “Free examinations and x-rays” or “complete braces at $2250” are examples. The permissibility of this form of advertising varies among the states. Informational advertising might state the credentials of the advertiser, the hours of operation, and the practice location, and it is considered to be the most ethical.3Graskemper J.P. Ethical advertising in dentistry.J Am Coll Dent. 2009; 76: 44-49PubMed Google Scholar The FTC's ease on advertising restrictions entrusts professionals with the liberty to self-modulate the content, tone, and presentation of their promotional efforts. This is a giant leap of trust and presumes that all members of a profession can equally discern what is professional and what is not. Although most us respect and cherish our well-earned professional stature, some are insensitive to the difference between blatant commercialism and maintenance of a professional image. A friend often said that orthodontics is a rough sport. “Just the way it is,” he'd say. I'd smile, since his statement could have a broad application. Now I'm starting to appreciate the accuracy of his perception. But I shouldn't have to, because it shouldn't be that way. Not if everyone uses just a little discretion.