Not too long ago, medical doctors were to be seen by patients - but certainly not heard on television, radio and in newspapers.
Touting their product in public was taboo.Their reputation was to be spread by word of mouth - someone else's mouth, that is. Satisfied patients told potential ones about good results. And the doctor's practice grew.
In short, advertising of any kind - while legal - was considered unethical.
That's before that culprit - competition - raised its ugly head. In the late 1960s, President Lyndon B. Johnson began building more medical schools and America trained more doctors.
To survive, doctors began using creative methods to attract and maintain patients. Out of pure necessity, physicians' attitudes about advertising and marketing have changed over the past 10 to 20 years.
"The profession no longer considers advertising unethical. A physician is free to advertise as much as he wishes, as long as the advertising isn't untrue or misleading," said J. Leon Sorenson, executive vice president of the Utah Medical Association.
"With the increased number of physicians who are practicing, more and more are turning to marketing as a way of obtaining and retaining patients."
This doesn't mean that all Utah physicians are launching extensive, expensive mass media campaigns.
Rather, most are self-promoting in more subtle ways - such as by volunteering to discuss health issues before community clubs and school classes, or becoming spokespersons and representatives for non-profit organizations
Some send out fliers propagandizing their practice, credentials and hours of availability. Others let hospital public relation staffs or advertising agencies do the promoting for them.
Most doctors are working longer hours, more weekends and holidays. After hours, they're staying at the office to return patients' calls. Some have even done the unspeakable - listed their home telephone numbers with US WEST.
Overall, they're paying more attention to the way their patients are treated.
"These techniques are all part of marketing," Sorenson said. "Most physicians use these before they actually get into advertising in the newspaper. Mass media advertising is more prevalent among large clinics, hospitals and health maintenance organizations which want to attract subscribers."
Some physicians still find it distasteful. But overt advertising is not restricted by professional medical societies. In fact, the Utah Medical Association holds annual seminars to teach doctor leaders how to work with the press.