Update March 20 2017
Dr Kevin Coleman promoted his myth, that the influenza immunisation led to his stroke, in Anti-Vaccination Australia:
Original post February 26 2017
On November 28 2015, readers were introduced to NSW Central Coast general practitioner, Dr Kevin Coleman, via this blog post: Dr Kevin Coleman – the antivaxers’ champion.
Coleman’s Facebook profile, now, as it was back in 2015, reads like a CV of his medical qualifications and medical employment. It is abundantly clear that Coleman uses his medical registration and employment on his social media, making every comment and post he publishes answerable under the Medical Board of Australia’s Code of Conduct, Guidelines for advertising regulated health services, and Social Media Policy (see the appendix at the end of this post for sections of these three documents):
- General Practitioner at Tuggerah Medical Centre
- Elective student at Angau Memorial General Hospital
- Former Principal General Practitioner at Cobar Medical Practice
- Former Medical Officer (M.O.) at Public Health Unit
- Former Research officer / DMO at Health Services Development Unit, Wits University
- Former MO in Neonatology at King Edward Materniy Hospital
- Former GP at Broome Regional Aboriginal Medical Service
- Former DMO at Katherine Base Hospital
- Former MO in Maternal & Child Health at Holy Cross Hospital
- Former MO in ICU, Senior Houseman in Medicine, ENT Surgery & Paediatrics at Baragwanath Hospital
- Former Doctor at Coronation Hospital
- Former Internship at St Vincent’s Hospital, Sydney
- Studied Medicine and Public Health at University of NSW
- Studied Tropical Medicine and Hygiene at Liverpool School of Tropical Medicine
- Studied at UNSW (The University of New South Wales)
To further introduce Coleman to newcomers, he also has history with regulators (from the 2015 blog post):
Coleman is no stranger to professional controversy. In 2010, Coleman was cautioned by the Medical Professional Standards Committee [inquiry PDF] for undertaking an inappropriate breast exam, without permission, on a patient. From the Health Care Complaints Commission publication:
The Health Care Complaints Commission recently prosecuted a complaint against Dr Kevin Thomas Coleman, a general practitioner, before a Medical Professional Standards Committee. The complaint alleged that Dr Coleman undertook a breast examination without the patient’s consent, without explaining to the patient the reason for the examination, and that the examination was inappropriate. It was further alleged that he failed to maintain adequate medical records.
In its decision of 12 April 2010, the Committee found Dr Coleman guilty of unsatisfactory professional conduct and cautioned him.
Coleman still has conditions attached to his registration. For example:
2. To practise only in a group practice (group is defined as at least 3 practitioners), with one other practitioner (supervisor) always on site. Nursing home and home visits are permitted if approved by the Medical Council of NSW.
3. To not consult, treat, interview or examine any female patient over the age of 13 years, whether in his surgery rooms, a nursing home or on house calls, unless a chaperone (an adult third person) is continuously present.
a) Prior to any such consultation, examination, treatment or interview, he must inform each female patient, or the parent or other adult carer of each child patient, of the necessity for a third person/chaperone to be present at all times.
And, importantly, note the final condition. Keep this in the back of your mind:
Registration is also subject to conditions that relate to personal health. Particulars are not published due to privacy considerations.
The impetus for the November 2015 blog post (apart from Coleman’s abundant anti-vaccination posts on various Facebook fora, also contained in the 2015 blog post), came on November 20 2015, when Coleman gave a speech to the poorly-attended No Jab No Pay No Way anti-vaccination protest rally, outside the offices of The Sunday Telegraph, in Sydney:
Some bullet-points from Coleman’s speech are as follows (also from the 2015 blog post):
- Coleman alludes to vaccines being a source of criminal behaviour
- Coleman asserts that there has not been enough research done on the vaccines/autism debate
- Coleman again asserts the flawed hypotheses that vaccines have not been studied appropriately, and that post-immunisation surveillance is not adequately carried out
- Coleman alleges that vaccine safety data is deliberately distorted
- Coleman alleges that accusations of vaccine injury are ignored, based on the claims of the anti-vaccine activists present
- Coleman alleges that general practitioners ignore the lifestyle factors of their patients in lieu of writing scripts
- Alarmingly, Coleman notes that he was admitted to a stroke unit in 2009, attributing his condition to an influenza immunisation
- Coleman mistakenly equates the real harm done by vaccine preventable disease, with the many made-up claims of vaccine injury, thus doing a great disservice to those he claims to honour
On November 29 2015, a complaint was lodged with the NSW Health Care Complaints Commission, based on the information contained in the 2015 blog post. This information consisted of the full transcript and video of the protest speech, as well as overwhelming evidence of his online activities in support of the anti-vaccination movement, and two articles quoting Coleman in Australian Doctor (also included in the 2015 blog post).
On March 30 2016, the complainant was sent the findings (redacted letter available here), from a weak and inadequate investigation based on addressing a Strawman: that Coleman is “not anti-vaccination”.
The issue at hand is clearly Coleman’s promotion of anti-vaccination misinformation – using his medical registration and his place of practise – on his social media, and at a public anti-vaccination rally, rather than whatever Coleman deems to call himself. For the record, it would be inaccurate to claim that Coleman is “anti-vaccine”. Coleman is not against all immunisations, by his own admission. He just shares a lot of anti-vaccine lies, dressed up as facts and “medical research”. From the March 30 2016 HCCC/Medical Council of NSW findings:
Dr Coleman has not consented to the release of his response and therefore I am unable to provide you with a copy.
I understand the main issue you had was with regards to Dr Coleman’s promotion of anti-vaccination and that he may be providing inaccurate information to the public which could lead to further illness and place further stress on the Australian healthcare system.
In his response Dr Coleman has advised the Commission that he is not anti-vaccination, but rather “pro-choice”. He believes that parents should be provided with objective, evidence based advice about vaccinations to enable them to make an informed decision about whether or not to vaccinate their child, rather than penalising them if they choose not to vaccinate.
Dr Coleman goes on to advise that he does not advocate for parents who do not vaccinate their children. He sympathises with both sides of the vaccination debate and shares his medical research on his facebook page. He does not provide advice to patients about vaccinations for their children and his interest in the issue is academic.
The Commission, in consultation with the Medical Council of NSW, has assessed your complaint and has decided to take no further action with this matter as from the information provided it appears that Dr Coleman is not advocating anti-vaccination but is advocating for the rights of the public to make their own informed decision.
However while Dr Coleman is entitled to his opinion this needs to be balanced with professional opinion which is positive toward vaccination.
Therefore the Commission, in consultation with the Medical Council of NSW has reminded Dr Coleman to make his position clear to patients that he is not advocating either for or against vaccination.
So, Coleman claims he is not anti-vaccine. Coleman claims he does not advocate for parents who do not immunise their kids. Coleman claims that he shares “his medical research” in sympathy with “both sides of the vaccination debate”. Coleman claims he is sharing information so that parents can make an “informed decision” about immunisation. And the HCCC and the Medical Council of NSW swallow it all: “Dr Coleman is not advocating anti-vaccination…”
One thing which stands out to any reader of Coleman’s social media is his overwhelming urge to post anti-vaccination material, and outright falsehoods, with an astonishing dearth of advocacy that parents should immunise their kids. Indeed, there would be appear to be only one side to this advocacy, given the weight of evidence which is published on Coleman’s social media, the odd comment equivocating about the benefits of some immunisation, notwithstanding.
Given the insipid investigation, and findings, above, into Coleman’s activism, one only needs to have a look at the sum of “his medical research” since the 2015 blog post which formed the basis of the rejected HCCC/Medical Council of NSW complaint.
On February 26 2017, on his profile, Coleman posted an article in which it is claimed that the HPV vaccine was responsible for the death of a girl. Regardless of the text contained in the article, Coleman implied that the vaccine has not been adequately tested for safety. It has. From the very article posted by Coleman:
“HPV (human papilloma virus) vaccine protects against cervical cancer, which can be a major killer of women, ” the statement said.
“Studies show that there are no serious safety concerns associated with HPV vaccine.”
According to the US Centre for Disease Control, one of the world’s leading medical authorities, “HPV vaccine is very safe, and it is effective at protecting against some HPV types that can be very bad.”
On February 23 2017, in Anti-Vaccination Australia, Coleman stated that there haven’t been any randomised controlled trials of vaccine safety, and entertained the admin of Anti-Vaccination Australia who had posted an anti-vaccination blog post:
On February 21 2017, on his Facebook profile, Coleman posted the anti-vaccination canard that vaccines haven’t had an effect on the decline in infectious disease and that this decline is due to hygiene and sanitation. The name of the website is “Medicine Kills Millions”:
On February 19 2017, Coleman called vaccination a “sacrament”, posting an incorrect claim that medical error is the third leading cause of death in the USA; it is not:
On February 19 2017, Coleman shared a video from anti-vaccination activist JB Handley, falsely claiming that there are no randomised controlled trials for the “sacrament” of vaccination:
On February 16 2017, Coleman stated that parents are “right to question vaccination”, based on his claim that “the medical system is corrupt”:
On February 16 2017, Coleman shared an article advocating for the infection of children with measles, and against immunisation, from discredited anti-vaccination micropaleontolgist, Viera Scheibner, who is not a vaccine researcher:
On November 21 2016, Coleman shared a post from the anti-vaccination page of the debunked anti-vaccine movie, Vaxxed, produced, directed by, and starring the disgraced anti-vaccination fraud, Andrew Wakefield:
On October 17 2016, Coleman shared an anti-vaccination conspiracy theory post:
On October 7 2016, Coleman shared a post from discredited anti-vaccination PhD graduate, Judy Wilyman, listing doctors who are anti-vaccine:
On October 3 2016, Coleman shared an anti-vaccination newsletter from Judy Wilyman:
On September 29 2016, Coleman shared a conspiracy theory post from anti-vaccination Facebook identity, Bev Pattenden, in which lies are published about the HPV vaccine:
On September 29 2016, Coleman shared a post from conspiracy theorist Bev Pattenden, containing a speech by anti-vaccination activist, Judy Wilyman:
On September 4 2016, Coleman shared this post by anti-vaccinationist, conspiracy theorist and fundamentalist Bev Pattenden. Pattenden believes that “evil” vaccination is a covert operation in which the population will be “micro-chipped” by “the devil and his demon helpers” who are intent on culling the population by “poisoning ourselves and our children” so as to have “less people on the planet”:
Welcome to all the new members. Please scroll down to read for a while before posting anything, to see if it is here before you post. I have to refuse quite a few posts, because they are here so many times before.
Posts that are outright promotions of vaccines will not be posted, but those who are open to debate usually are.
This is an anti-vax/pro choice group, meaning I am now anti-vax, but I realize that some still want to vaccinate, and that is their choice.
That is what this is all about. “the freedom to choose”, which will be destroyed if we allow ourselves to be micro-chipped.
Please realize that this is a spiritual battle as well as a temporal one.
The devil and his demon helpers do not really care if you are an atheist, an agnostic, or what “religion” you are, they just want you to harden your heart against God, so that you cannot learn the truth.
The longer you resist the truth, the harder it becomes to accept it when it comes along. Some will never learn, and the parable of the seeds, as explained by Jesus tells it well.
Mark 4:13-20.
But still we must continue to explain the evil of vaccinations, that has captured the soul of so many for so long, in which we are told that poisoning ourselves and our children was good for our health.
It is, and was a lie, propagated by those who benefit financially and want less people on the planet.
On September 4 2016, Coleman shared an anti-vaccination, conspiracy theory post:
On August 29 2016, Coleman shared an anti-vaccination post, in which it is claimed that vaccines are responsible for conditions unrelated to vaccination:
On August 11 2016, Coleman promoted a publication written by an anti-vaccination conspiracy theorist and an anti-vaccination researcher:
On August 5 2016, Coleman astonishingly appeared to make a direct link between historic iatrogenic HIV/AIDS infections, and the government’s No Jab No Pay immunisation and child care policy. Coleman was congratulated as a “great man” by anti-vaccination activist Trent Wiseman, a carpenter from Melbourne:
On July 24 2016, Coleman promoted Sydney naturopath Marilyn Bodnar, who was committed to stand trial in the near-starving-death of a baby under her healthcare supervision:
On May 28 2016, Coleman promoted a demonstrably false anti-vaccination lie about Irish nuns and the deaths of orphans in Ireland:
On May 19 2016, Coleman promoted dangerous claims regarding Vitamin C and miracle cures. Coleman sourced his medical information from anti-vaccination carpenter, Trent Wiseman:
On May 2 2016, Coleman promoted the anti-vaccination movie, Vaxxed, produced and directed by, and starring anti-vaccination fraud Andrew Wakefield:
On April 4 2016, Coleman shared a post from Truthkings, the conspiracy theory website of anti-vaccination activist, Sherri Tenpenny:
On April 4 2016, Coleman shared what appears to be the only PubMed article on his Facebook profile, a study by disgraced anti-vaccination father-and-son team, the Geiers. The father, Mark Geier, has had his medical licence revoked in the US, due to his unethical practise of medicine. Geier used Lupron to chemically castrate autistic boys, based on his flawed belief that an overabundance of testosterone was implicated in autism in boys:
On February 22 2016, Coleman promoted the Facebook pages of anti-vaccination activist, Judy Wilyman, and fake cancer cure businessman, Ian Gawler:
On February 5 2016, Coleman shared an anti-vaccination article about measles:
On February 5 2016, Coleman, again, shared the anti-vaccination post regarding measles, falsely equivocating the pros and cons of measles immunisation:
On January 22 2016, Coleman shared a post from anti-Semitic, homophobic, Islamophobic, Port Arthur denialism website, The Crazz Files, in which conspiracy theories about the Hammond family are promoted:
On January 6 2016, Coleman shared anti-vaccination lies about measles immunisation and measles deaths:
On January 6 2016, Coleman showed that he does not fully understand the significance of using measles mortality data in arguing against the efficacy of measles immunisation. Anyone with basic knowledge of the anti-vaccination movement knows that anti-vaccination activists dishonestly argue that measles immunisation is ineffective, based not on measles notifications, but, on mortality data. Of course, modern medicine got better and better at preventing deaths from measles, hence the decline before widespread immunisation. This is separate from measles notifications, or morbidity data. Coleman states, “This is impressive!”, of the mortality graph he posted:
On December 31 2015, Coleman stated that influenza immunisation is a “scam”:
On December 30 2015, Coleman promoted the hideous website of anti-vaccination entrepreneur, Stephanie Messenger, and her dangerous anti-vaccination children’s book, Melanie’s Marvelous Measles, in which it is advocated that getting measles is beneficial for children:
On December 28 2015, Coleman stated that the government’s No Jab No Pay legislation is “scientifically hazardous”, and claimed that “long term, transgenerational impact of vaccines” is not researched, thereby ignoring the existence of post-marketing surveillance:
On December 22 2015, Coleman shared the anti-vaccination lies about the Irish nuns and deaths of orphans:
On December 20 2015, Coleman promoted this anti-vaccination blog post:
On November 28 2015, Coleman shared this article from 2011 in which it is argued that the Gardasil vaccine is dangerous. The court case against Gardasil has disappeared. Coleman also asked a series of questions which are already answered in the Gardasil product information, easily available on the internet:
On November 27 2015, Coleman promoted the Gardasil court case, claiming that Gardasil safety data must somehow be hidden; it isn’t:
Given the regulatory importance placed upon the dangerous anti-vaccination activities of nurses and midwives, and chiropractors, by the Nursing and Midwifery Board of Australia, and the Chiropractic Board of Australia, one must hope – hopefully not in vain – that the Medical Board of Australia takes these alleged breaches seriously, this time.
We must compare the activities of Dr Kevin Coleman with those of practitioners already sanctioned by the NMBA and the CBA, and wonder what uproar would follow if that which still appears on Coleman’s social media was still available on any nurse or chiropractor’s pages. How many more “reminders” does the Medical Council of NSW and the HCCC afford Dr Coleman? The medical community, and medical associations, cannot remain silent on this egregious case. Not any more.
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Appendix
Good medical practice: a code of conduct for doctors in Australia
1.2 Use of the code
Doctors have a professional responsibility to be familiar with Good medical practice and to apply the guidance it contains.
This code will be used:
- to support individual doctors in the challenging task of providing good medical care and fulfilling their professional roles, and to provide a framework to guide professional judgement
- to assist the Medical Board of Australia in its role of protecting the public, by setting and maintaining standards of medical practice against which a doctor’s professional conduct can be evaluated. If your professional conduct varies significantly from this standard, you should be prepared to explain and justify your decisions and actions. Serious or repeated failure to meet these standards may have consequences for your medical registration
- as an additional resource for a range of uses that contribute to enhancing the culture of medical professionalism in the Australian health system; for example, in medical education; orientation, induction and supervision of junior doctors and international medical graduates; and by administrators and policy makers in hospitals, health services and other institutions.
The code applies in all settings. It is valid for technology-based patient consultations as well as for traditional face-to-face consultations and also applies to how doctors use social media. To guide doctors further, the Medical Board of Australia has issued Guidelines for technology-based patient consultations.
1.4 Professional values and qualities of doctors
While individual doctors have their own personal beliefs and values, there are certain professional values on which all doctors are expected to base their practice.
Doctors have a duty to make the care of patients their first concern and to practise medicine safely and effectively. They must be ethical and trustworthy.
Patients trust their doctors because they believe that, in addition to being competent, their doctor will not take advantage of them and will display qualities such as integrity, truthfulness, dependability and compassion. Patients also rely on their doctors to protect their confidentiality.
Doctors have a responsibility to protect and promote the health of individuals and the community.
Good medical practice is patient-centred. It involves doctors understanding that each patient is unique, and working in partnership with their patients, adapting what they do to address the needs and reasonable expectations of each patient. This includes cultural awareness: being aware of their own culture and beliefs and respectful of the beliefs and cultures of others, recognising that these cultural differences may impact on the doctor–patient relationship and on the delivery of health services.
Good communication underpins every aspect of good medical practice.
Professionalism embodies all the qualities described here, and includes self-awareness and self-reflection. Doctors are expected to reflect regularly on whether they are practising effectively, on what is happening in their relationships with patients and colleagues, and on their own health and wellbeing. They have a duty to keep their skills and knowledge up to date, refine and develop their clinical judgement as they gain experience, and contribute to their profession.
2.2 Good patient care
Maintaining a high level of medical competence and professional conduct is essential for good patient care. Good medical practice involves:
- Recognising and working within the limits of your competence and scope of practice.
- Ensuring that you have adequate knowledge and skills to provide safe clinical care.
- Maintaining adequate records (see Section 8.4).
- Considering the balance of benefit and harm in all clinical-management decisions.
- Communicating effectively with patients (see Section 3.3).
- Providing treatment options based on the best available information.
- Taking steps to alleviate patient symptoms and distress, whether or not a cure is possible.
- Supporting the patient’s right to seek a second opinion.
- Consulting and taking advice from colleagues, when appropriate.
- Making responsible and effective use of the resources available to you (see Section 5.2).
- Encouraging patients to take interest in, and responsibility for, the management of their health, and supporting them in this.
- Ensuring that your personal views do not adversely affect the care of your patient.
4.2 Respect for medical colleagues and other healthcare professionals
Good patient care is enhanced when there is mutual respect and clear communication between all healthcare professionals involved in the care of the patient. Good medical practice involves:
- Communicating clearly, effectively, respectfully and promptly with other doctors and healthcare professionals caring for the patient.
- Acknowledging and respecting the contribution of all healthcare professionals involved in the care of the patient.
- Behaving professionally and courteously to colleagues and other practitioners including when using social media.
5.3 Health advocacy
There are significant disparities in the health status of different groups in the Australian community. These disparities result from social, cultural, geographic, health related and other factors. In particular, Aboriginal and Torres Strait Islander Australians bear the burden of gross social, cultural and health inequity. Good medical practice involves using your expertise and influence to protect and advance the health and wellbeing of individual patients, communities and populations.
5.4 Public health
Doctors have a responsibility to promote the health of the community through disease prevention and control, education and screening. Good medical practice involves:
- Understanding the principles of public health, including health education, health promotion, disease prevention and control and screening.
- Participating in efforts to promote the health of the community and being aware of your obligations in disease prevention, screening and reporting notifiable diseases.
6.3 Doctors’ performance – you and your colleagues
The welfare of patients may be put at risk if a doctor is performing poorly. If you consider there is a risk, good medical practice involves:
- Complying with any statutory reporting requirements, including the mandatory reporting requirements under the National Law as it applies in your jurisdiction.10
- Recognising and taking steps to minimise the risks of fatigue, including complying with relevant state and territory occupational health and safety legislation.
- If you know or suspect that you have a health condition that could adversely affect your judgement or performance, following the guidance in Section 9.2 Your health.
- Taking steps to protect patients from risk posed by a colleague’s conduct, practice or ill health.
- Taking appropriate steps to assist your colleague to receive help if you have concerns about a colleague’s performance or fitness to practise.
- If you are not sure what to do, seeking advice from an experienced colleague, your employer, doctors’ health advisory services, professional indemnity insurers, the Medical Board of Australia or a professional organisation.
7.2 Continuing professional development
The Medical Board of Australia has established registration standards that set out the requirements for continuing professional development and for recency of practice under the National Law.11
Development of your knowledge, skills and professional behaviour must continue throughout your working life. Good medical practice involves:
- Keeping your knowledge and skills up to date.
- Participating regularly in activities that maintain and further develop your knowledge, skills and performance.
- Ensuring that your practice meets the standards that would be reasonably expected by the public and your peers.
- Regularly reviewing your continuing medical education and continuing professional development activities to ensure that they meet the requirements of the Medical Board of Australia.
- Ensuring that your personal continuing professional development program includes self-directed and practice-based learning.
9.2 Your health
Good medical practice involves:
- Having a general practitioner.
- Seeking independent, objective advice when you need medical care, and being aware of the risks of self-diagnosis and self-treatment.
- Making sure that you are immunised against relevant communicable diseases.
- Conforming to the legislation in your state or territory in relation to self-prescribing.
- Recognising the impact of fatigue on your health and your ability to care for patients, and endeavouring to work safe hours wherever possible.
- Being aware of the doctors’ health program in your state or territory if you need advice on where to seek help.
- If you know or suspect that you have a health condition or impairment that could adversely affect your judgement, performance or your patient’s health:
- not relying on your own assessment of the risk you pose to patients
- consulting your doctor about whether, and in what ways, you may need to modify your practice, and following the doctor’s advice.
9.3 Other doctors’ health
Doctors have a responsibility to assist medical colleagues to maintain good health. All health professionals have responsibilities in certain circumstances for mandatory notification under the National Law.16 Good medical practice involves:
- Providing doctors who are your patients with the same quality of care you would provide to other patients.
- Notifying the Medical Board of Australia if you are treating a doctor whose ability to practise may be impaired and may thereby be placing patients at risk. This is always a professional, and in some jurisdictions, a statutory responsibility under the National Law.
- Encouraging a colleague (whom you are not treating) to seek appropriate help if you believe they may be ill and impaired. If you believe this impairment is putting patients at risk, notify the Medical Board of Australia. It may also be wise to report your concerns to the doctor’s employer and to a doctors’ health program.
- Recognising the impact of fatigue on the health of colleagues, including those under your supervision, and facilitating safe working hours wherever possible.
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Guidelines for advertising regulated health services
6.2 Prohibited advertising under the National Law
Section 133 of the National Law prohibits advertising that:
- is false, misleading or deceptive or is likely to be so
- offers a gift, discount or other inducement to attract a user of the health service without stating the terms and conditions of the offer
- uses testimonials or purported testimonials
- creates an unreasonable expectation of beneficial treatment, and/or
- encourages the indiscriminate or unnecessary use of health services.
The sections below explain each part of section 133.
6.2.1 Misleading or deceptive advertising
Section 133 of the National Law states:
- A person must not advertise a regulated health service, or a business that provides a regulated health service, in a way that –
- Is false, misleading or deceptive or is likely to be misleading or deceptive
A common meaning of ‘mislead or deceive’ is ‘lead into error’. The courts have considered the phrase ‘mislead or deceive’. People who are misled are almost by definition deceived as well. Misleading someone may include lying to them, leading them to a wrong conclusion, creating a false impression, leaving out (or hiding) important information, and/or making false or inaccurate claims.
As the ACCC explains, ‘Patients can be physically, psychologically or financially affected by misleading conduct, and these effects can be long lasting. It is essential that patients be given honest, accurate and complete information in a form they can understand.’5
Examples of advertising that may be false or misleading include those that:
- mislead, either directly, or by implication, use of emphasis, comparison, contrast or omission
- only provide partial information which could be misleading
- use phrases like ‘as low as’ or ‘lowest prices’, or similar words or phrases when advertising fees for services, prices for products or price information in a way which is misleading or deceptive
- imply that the regulated health services can be a substitute for public health vaccination or immunisation
- use words, letters or titles that may mislead or deceive a health consumer into thinking that the provider of a regulated health service is more qualified or more competent than a holder of the same registration category (e.g. ‘specialising in XX’ when there is no specialist registration category for that profession)
- advertise the health benefits of a regulated health service when there is no proof that such benefits can be attained,6and/or
- compare different regulated health professions or practitioners, in the same profession or across professions, in a way that may mislead or deceive.
Using comparative advertising often risks misleading and/or deceiving the public because it can be difficult to include complete information when comparing one health service with another.
The ACCC has provided tips on how to avoid being misleading and deceptive when advertising. They may be useful for advertisers considering the requirements of the National Law:
- Sell your professional services on their merits.
- Be honest about what you say and do commercially.
- Look at the overall impression of your advertisement. Ask yourself who the audience is and what the advertisement is likely to say or mean to them.
- Remember, at a minimum, that it is the viewpoint of a layperson with little or no knowledge of the professional service you are selling that should be considered.7
More information about the meaning of ‘mislead or deceive’ is available on the ACCC website.
6.2.2 Gifts and discounts
Section 133 of the National Law states:
- A person must not advertise a regulated health service, or a business that provides a regulated health service, in a way that –
- Offers a gift, discount or other inducement to attract a person to use the service or the business, unless the advertisement also states the terms and conditions of the offer
Any advertisement that offers gifts, prizes or free items must state the terms and conditions of the offer.
The use of unclear, unreadable or misleading terms and conditions attached to gifts, discounts and other inducements would not meet this requirement.
Consumers generally consider the word ‘free’ to mean absolutely free. When the costs of a ‘free offer’ are recouped through a price rise elsewhere, the offer is not actually free. An example is an advertisement which offers ‘make one consultation appointment, get one free’, but raises the price of the first consultation to largely cover the cost of the second (free) appointment. This type of advertising could also be misleading or deceptive.
The terms and conditions should be in plain English, readily understandable, accurate and not in themselves misleading about the conditions and limitations of the offered service.
Advertising may contravene the National Law when it:
- contains price information that is inexact
- contains price information that does not specify any terms and conditions or variables to an advertised price, or that could be considered misleading or deceptive
- states an instalment amount without stating the total cost (which is a condition of the offer), and/or
- does not state the terms and conditions of offers of gifts, discounts or other inducements.
6.2.3 Testimonials
Section 133 of the National Law states:
- A person must not advertise a regulated health service, or a business that provides a regulated health service, in a way that –
- Uses testimonials or purported testimonials about the service or business
The National Law does not define ‘testimonial’, so the word has its ordinary meaning of a positive statement about a person or thing. In the context of the National Law, a testimonial includes recommendations, or statements about the clinical aspects of a regulated health service.
The National Law ban on using testimonials means it is not acceptable to use testimonials in your own advertising, such as on your Facebook page, in a print, radio or television advertisement, or on your website. This means that::
- you cannot use or quote testimonials on a site or in social media that is advertising a regulated health service, including patients posting comments about a practitioner on the practitioner’s business website, and
- you cannot use testimonials in advertising a regulated health service to promote a practitioner or service.
Health practitioners should therefore not encourage patients to leave testimonials on websites health practitioners control that advertise their own regulated health services, and should remove any testimonials that are posted there.
The National Law does not directly regulate social media. However, testimonials used in advertising a regulated health service through social media may contravene the National Law.
There are many opportunities for consumers or patients to express their views online that are not affected by the National Law restriction on testimonials in advertising. Patients can share views through their personal social media such as Facebook or Twitter accounts or on information sharing websites or other online mechanisms that do not involve using testimonials in advertising a regulated health service.
For example, consumer and patient information sharing websites that invite public feedback/reviews about experience of a regulated health practitioner, business and/or service are generally intended to help consumers make more informed decisions and are not considered advertising of a regulated health service.
To clarify, practitioners are not responsible for removing (or trying to have removed) unsolicited testimonials published on a website or in social media over which they do not have control.
6.2.4 Unreasonable expectation of beneficial treatment
Section 133 of the National Law states:
- A person must not advertise a regulated health service, or a business that provides a regulated health service, in a way that –
- Creates an unreasonable expectation of beneficial treatment
This can arise when advertisers take advantage of the vulnerability of health consumers in their search for a cure or remedy. The claims of beneficial treatment can range from unsubstantiated scientific claims, through to miracle cures. Advertising of treatments or services must not encourage or promote unreasonable expectations.
For example, advertising may contravene the National Law when it:
- creates an unreasonable expectation (such as by exaggerating or by providing incomplete or biased information) of recovery time after providing a regulated health service
- fails to disclose the health risks associated with a treatment
- omits the necessary warning statement about a surgical or invasive procedure9
- contains any inappropriate or unnecessary information or material that is likely to make a person believe their health or wellbeing may suffer from not taking or undertaking the health service, and/or
- contains a claim, statement or implication that is likely to create an unreasonable expectation of beneficial treatment
– either expressly, or by omission, indicating that the treatment is infallible, unfailing, magical, miraculous or a certain, guaranteed or sure cure, and/or
– practitioner has an exclusive or unique skill or remedy, or that a product is ‘exclusive’ or contains a ‘secret ingredient’ that will benefit the patient.6.2.5 Encouraging indiscriminate or unnecessary use of health services
Section 133 of the National Law states:
- A person must not advertise a regulated health service, or a business that provides a regulated health service, in a way that –
- Directly or indirectly encourages the indiscriminate or unnecessary use of regulated health services
The unnecessary and indiscriminate use of regulated health services is not in the public interest and may lead to the public purchasing or undergoing a regulated health service that they do not need or require.\
Advertising may contravene the National Law when it:
- encourages a person to improve their physical appearance together with the use of phrases such as ‘don’t delay’, ‘achieve the look you want’ and ‘looking better and feeling more confident’
- provides a patient or client with an unsolicited appointment time
- uses prizes, bonuses, bulk purchases, bulk discounts or other endorsements to encourage the unnecessary consumption of health services that are unrelated to clinical need or therapeutic benefit
- uses promotional techniques that are likely to encourage consumers to use health services regardless of clinical need or therapeutic benefit, such as offers or discounts, online/internet deals, vouchers, and/or coupons, and/or
- makes use of time-limited offers which influence a consumer to make decisions under the pressure of time and money rather than about their health care needs. An offer is considered time-limited if it is made to purchase for a limited or specific period of time, or available for use within a limited period of time or by a specific date, without an option to exit the arrangement.
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When using social media, health practitioners should remember that the National Law, their National Board’s code of ethics and professional conduct (the Code of conduct) and the Guidelines for advertising regulated health services (the Advertising guidelines) apply.
Registered health practitioners should only post information that is not in breach of these obligations by:
- complying with professional obligations
- complying with confidentiality and privacy obligations (such as by not discussing patients or posting pictures of procedures, case studies, patients, or sensitive material which may enable patients to be identified without having obtained consent in appropriate situations)
- presenting information in an unbiased, evidence-based context, and
- not making unsubstantiated claims.
Additional information may be available from professional bodies and/or employers, which aims to support health practitioners’ use of social media. However, the legal, ethical, and professional obligations that registered health practitioners must adhere to are set out in the National Boards’ respective Code of conduct and the Advertising guidelines.
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