Truth-in-Advertising Laws: Are They Working? A Cross-Sectional Analysis of a “Plastic Surgeon” Patient Search Simulation

Abstract

Background: Non–board-certified plastic surgeons performing cosmetic procedures and advertising as plastic surgeons may have an adverse effect on a patient’s understanding of their practitioner’s medical training and patient safety. The authors aim to assess (1) the impact of city size and locations and (2) the impact of health care transparency acts on the ratio of board-certified and non–American Board of Plastic Surgeons physicians. Methods: The authors performed a systematic Google search for the term “plastic surgeon [city name]” to simulate a patient search of online providers. Comparisons of board certification status between the top hits for each city were made. Data gathered included city population, regional location, practice setting, and states with the passage of truth-in-advertising laws. Results: One thousand six hundred seventy-seven unique practitioners were extracted. Of these, 1289 practitioners (76.9 percent) were American Board of Plastic Surgery–certified plastic surgeons. When comparing states with truth-in-advertising laws and states without such laws, the authors found no significant differences in board-certification rates among “plastic surgery” practitioners (88.9 percent versus 92.0 percent; p = 0.170). There was a significant difference between board-certified “plastic surgeons” versus out-of-scope practitioners on Google search between large, medium, and small cities (100 percent versus 92.9 percent versus 86.5; p < 0.001). Conclusions: Non–board-certified providers tend to localize to smaller cities. Truth-in-advertising laws have not yet had an impact on the way a number of non–American Board of Plastic Surgery–certified practitioners market themselves. There may be room to expand the scope of truth-in-advertising laws to the online world and to smaller cities.

Board Certification in Cosmetic Surgery

“…However, truth in advertising legislation present in several states (eg, California, Florida, Nevada, New Jersey) mandates that physicians can only claim to be "board certified" if the certifying board is an ABMS member or deemed equivalent. [14][15][16][17] Because of ABCS certification not necessitating completion of an ACGME-or American Osteopathic Association-accredited training program in cosmetic surgery, the ABCS has not viewed as an ABMS equivalent by some state medical boards (exceptions include Texas and Oklahoma). [14][15][16][17] However, given the dynamic and largely unregulated nature of the online marketplace, truth in advertising legislation can be difficult to enforce.…”

“…One study found no appreciable difference in the rates of non-ABPS-certified practitioners advertising as "plastic surgeons" between states with and without truth in advertising laws. 15 Furthermore, many ABCS diplomates include their ABCS credential when emphasizing their multiple qualifications, either by listing it alongside other board certifications or by counting it toward their total number of board certifications (eg, "triple board certified"). Without an understanding of the differences between board certifications, these actions can potentially exacerbate public confusion about differing board certifications.…”

“…[14][15][16][17] Because of ABCS certification not necessitating completion of an ACGME-or American Osteopathic Association-accredited training program in cosmetic surgery, the ABCS has not viewed as an ABMS equivalent by some state medical boards (exceptions include Texas and Oklahoma). [14][15][16][17] However, given the dynamic and largely unregulated nature of the online marketplace, truth in advertising legislation can be difficult to enforce. One study found no appreciable difference in the rates of non-ABPS-certified practitioners advertising as "plastic surgeons" between states with and without truth in advertising laws.…”

“…In addition, nearly 70% of ABCS diplomates use their ABCS credential to market themselves as “board-certified” cosmetic surgeons on their professional Web sites. However, truth in advertising legislation present in several states (eg, California, Florida, Nevada, New Jersey) mandates that physicians can only claim to be “board certified” if the certifying board is an ABMS member or deemed equivalent 14–17 . Because of ABCS certification not necessitating completion of an ACGME– or American Osteopathic Association-accredited training program in cosmetic surgery, the ABCS has not viewed as an ABMS equivalent by some state medical boards (exceptions include Texas and Oklahoma) 14–17 .…”

“…13 Furthermore, the American Medical Association has advocated for truth in advertising legislation mandating that only physicians certified by an ABMS member board or equivalent (eg, American Board of Facial Plastic and Reconstructive Surgery) can advertise themselves as "board certified." [14][15][16][17] Both campaigns help empower patients to make informed decisions when selecting an aesthetic surgeon. However, the effectiveness of patient education is limited by a largely unregulated online marketplace with respect to the use of certain phrases, such as "board certified" and "plastic surgeon."…”