The Physiotherapy Board (Board) recognises the value of providing information to the public about practitioners and the services they provide and that advertising can provide a means of conveying such information. Any information provided in an advertisement for a service should be reliable and useful in assisting consumers to make informed decisions about accessing services and health care choices.
Advertising can have adverse consequences when it is false, inaccurate, misleading or deceptive, and can lead to the provision of inappropriate or unnecessary health services, or create unrealistic expectations.
Advertising means any information published about your practice, including but not limited to, signage, corporate printing such as business cards, stationery, and social and print media such as websites, Facebook, LinkedIn, newspapers.
The purpose of this statement is to protect the public from advertising that is false, misleading or deceptive and to guide physiotherapists about the advertising of health-related products and services. This will support the appropriate use of health resources and ensure that patients can make informed decisions about their health care.
New Zealand law
Health Practitioners Competence Assurance Act 2003 includes protecting the public by only allowing qualified people to claim to be health practitioners (Section 7). It stipulates the necessity of a current practising certificate issued by the responsible authority within a scope of practice (Section 8) and entering particulars of qualifications on the register (Section 138(1)).
The Advertising Standards Authority Advertising Codes (including the Therapeutic Products Advertising Code, Therapeutic Services Advertising Code, and Advertising Code of Ethics) are also relevant. This has specific information relating to the use of patient testimonials to consumers.
Practitioners must also be aware of other legislation and standards relating to advertising including, but not limited to, the Fair Trading Act 1986, Consumer Guarantees Act 1993, Code of Health and Disability Services Consumers’ Rights, and the Advertising Standards Authority’s Codes.
1. Professional obligations
1.1. Ethical standards
The Aotearoa New Zealand Physiotherapy Code of Ethics and Professional Conduct (2017) states:
6.1: Physiotherapists must provide truthful, accurate and relevant information and must not knowingly make misleading representations to patients and those legally entitled or authorised to receive information.
10.5: Physiotherapists must when engaged in advertising or promotion:
- Claim only those titles and qualifications to which they are entitled and ensure that any perceived or actual misperceptions about qualifications are avoided and corrected.
- Must not use any advertising methods and/or material that bring the profession into disrepute.
- Not engage in any conduct that is misleading as to the nature, characteristics, effectiveness, and/or suitability of any product, and/or service.
The example of advertising ‘free physio’ is misleading for patients whose management is subsidised by an insurer or funder e.g. ACC, Southern Cross, PHO.
1.2. Public safety
Practitioners must not advertise in a manner that could be considered as an attempt to profit from or take advantage of limited consumer understanding. It is inappropriate for a physiotherapist to prejudge a patient’s ability to afford a particular treatment, or the value that a patient puts on any treatment.
1.3. Informed consent
Informed consent has specific parameters as set out in the Board’s Informed consent standard. The main purpose for the advertising of services is to present information that is reasonably required by consumers to make decisions about the services offered and should not be used for informed consent.
1.4. Ensuring competence
When advertising a service, a practitioner must be competent by reason of his or her education, training and/or experience to provide the service advertised or to act in the manner or professional capacity advertised. A practitioner must be certain that any claims made in advertising material can be supported by best available evidence. This refers particularly to claims regarding outcomes of treatment, whether implied or explicitly stated.
1.5. Comparative advertising
It is difficult to include all required information to avoid a false or inaccurate comparison when comparing one health service or product with another. Therefore, comparative advertising contains a risk of misleading the public. Practitioners must not advertise in any way, which disparages other practitioners and the services they offer.
1.6. Authorising the content of advertising
Practitioners are responsible for the form and content of the advertising of health-related services and products associated with their practice. Practitioners must not delegate this responsibility. If you hold responsibility for management or governance within a corporate organisation, you may reasonably be held responsible for the content of any advertising published by that organisation.
You also have some responsibility in situations in which you make yourself available, or provide information to, media reports, magazine articles, ‘reality’ shows or advertorials. In such circumstances, you are responsible for the comments you make and the information you provide.
1.7. Appropriate language and images
Language and images convey powerful messages about physiotherapy practice that reflect on the whole profession. Care is needed with language and when using images in advertising to ensure that they avoid unnecessary stereotyping and are culturally appropriate. Careful use should be made of models in a state of undress, images of skeletons or other graphical representations of the body, and images that could be deemed offensive. Care should always be taken to ensure the correct copyright permissions, and appropriate consent have been arranged before publication.
2. Advertising nature of practice
The use of the term Specialist: a physiotherapist who does not hold specialist registration must not claim or otherwise hold him or herself out to be a specialist, either explicitly or by implication, or convey that perception to the public.
3. Advertising of professional qualifications and memberships
Advertising titles, professional qualifications or memberships may be useful in providing the public with information about experience and expertise. These may be misleading or deceptive if patients can interpret the advertisements to imply that you are more skilled or have greater experience than is the case. Professional qualifications are those qualifications obtained from reputable institutions by examination or formal assessment.
Advertisements must not unduly glamorise products and services or foster unrealistic expectations. Testimonials can create an unrealistic expectation of outcomes for individual patients and must not be used or quoted in your advertising or on any websites, social media forums or any other platforms you control that advertise your services.
5. Discount coupons or gift certificates
If you advertise using discount coupons or gift certificates, you must ensure that these do not undermine your relationship with the patient and the informed consent process. In particular, you must ensure that your coupon or certificate is clear that:
- purchase of the certificate or coupon does not equate to granting informed consent
- ensure the assessment and treatment is necessary and appropriate
- before treatment, you will discuss treatment options with the patient
- the patient has the right to opt out of treatment at any time
- you will not provide the requested treatment if your assessment indicates that the patient is not a suitable candidate.
6. Consequences of breach of advertising requirements
If you have a concern about advertising, you should contact the Board. Where advertising appears to breach a code or law, the Board may refer complaints to another agency, such as the NZ Advertising Standards Complaints Board or the Commerce Commission.
This practice standard may be used by the Health Practitioners Disciplinary Tribunal, the Board, and the Health and Disability Commissioner as a standard by which a physiotherapist’s conduct is measured. At the conclusion of an investigation by another agency, the Board may initiate a conduct review, which could result in additional sanctions.
Aotearoa New Zealand Code of Ethics and Professional Conduct (2018) Principle 10.5
Physiotherapy Practice thresholds for Australia & Aotearoa New Zealand (2015) Key competencies 2.1 and 3.1
This statement is scheduled for review in 2023. Legislative changes may make this statement obsolete before this review date.
This document has relied heavily on the Dental Council, and Medical Council of New Zealand’s Standards as these Health Professionals face similar issues. We acknowledge the Dental Council and the Medical Council of New Zealand for their generosity in allowing us to use and appropriately amend their documents.