Consumer response to physicians’ advertisements

Consumer Response to Physicians' Advertisements

Dr. Ronald B. Marks University of Wisconsin-Oshkosh

An important national issue is the containment of health care costs. In recent years, health care expenditures have grown more rapidly than infla- tion itself and consume an ever increasing proportion of the Gross National Product (Business Week, 1982). A number of proposals have been advanced to limit this growth, many of which would try to induce more competition into the system (Business Week, 1982). The recent impetus of the Federal Trade Commission in seeking the removal of professional societies' prohi- bitions against advertising is also expected to have an impact in the containment process. In a recent interview regarding health care costs, HEW Secretary Patricia Harris noted that the government has been encouraging advertising by professionals and "the real key is whether the advertising brings competition into this area" (Daily Northwestern, 1981). This research study addresses itself to determining the potential effects of physicians' advertising with regard to price, service, and qualifications, a question that has received little empirical attention.

BACKGROUND

Prior to 1975, research regarding the impact of professional advertising would have made little sense. Until then, the health and legal professions operated without fear of government investigation into anti-competitive practices. However, in 1975, in the landmark case of Goldfarb vs. Virginia State Bar, the Supreme Court asserted that legal societies were subject to antitrust legislation (Camper and Footlick, 1975). The minimum fee schedule imposed by the Virginia State Bar association was abolished by court order with Chief Justice Burger calling the schedule "a classic illustration of price fixing" (Camper and Footlick, 1975). On June 27, 1977, in a case

�9 1984, Academy of Marketing Science, Journal of the Academy of Marketing Science Summer, 1984, Vol. 12, No. 35-52

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36 CONSUMER RESPONSE TO PHYSICIANS' ADVERTISEMENTS

with even greater implications for professional advertising, Bates and O'Steen vs. the Arizona Bar, the Supreme Court removed most of the restrictions on advertising legal fees and services (Moskowitz, 1977).

In 1976, the Supreme Court made its first decision relevant to the advertising of health care services, when it cleared the way for pharmacists to advertise the prices of prescription drugs (Wall Street Journal, 1976). Two years later, the Federal Trade Commission adopted a rule that prohibits states and professional groups from banning advertisements for eyeglasses, contact lenses and eye examinations (Wall Street Journal, 1978).

In 1978, Edward G. Barnes, administrative law judge with the Federal Trade Commission, ruled that the American Medical Association's code of ethics illegally restrained competition among doctors by preventing them from advertising. This decision orginally stemmed from a 1975 FIC com- plaint against the A.M.A. and two Connecticut member societies (Time, 1978). In making the decision, Barnes commented (Medical Economics, 1979):

Substantial anti-competitive effects have resulted. Phys ' .ans have been prevented from seeking customers by offering to provide services at a particular price or by advertising their availability or qualification. This has made it more difficult for consumers to comparison-shop for physician's services, to lo- cate physicians upon first arriving in a community, (and) to change physicians . . .

This decision was upheld by the Second Court of Appeals in New York. The American Medical Association had appealed the original FTC decision, arguing that, as a nonprofit organization, it was not subject to the jurisdiction of the FIC. However, the court, in a majority decision, noted that "the record satisfied us that the petitioner services both the business and non- business interests of member physicians" (Choudhury, 1981). Following this appellate court decision, the AMA appealed the case to the Supreme Court. In March, 1982, by tie vote, the Supreme Court left intact the original FIC ruling permitting doctors to advertise. The AMA lobbied hard in Congress for exemption from FTC jurisdiction and made inroads in both the Senate and the House, especially the latter where a bill was passed that totally exempted doctors from FIC jurisdiction. The Senate bill had ap- proved only some curbs, prompting attempted resolution by a joint conference committee, but they failed to reach agreement, leaving intact the original court ruling allowing physician advertising (Wall Street Journal, 1982).

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Issues

The basic arguments in favor of professional advertising (implied in administrative law judge Barnes'statement) are well summarized by Bloom (1977). Advocates would argue that advertising should help to produce lower prices, better quality professional services, and more efficient use of resources by:

(1)Providing patients and clients with inexpensive information regarding attributes of professionals.

(2)Allowing examination of more professionals without increasing the costs of searching for information.

(3)Making it more difficult to charge excessive prices or to supply services of inferior quality.

(4)Stimulating professionals to compete to offer better service (e.g. location, hours, means of payment, etc.).

Whether, in fact, physicians' advertising would bring about these salutary results is not without controversy. There exist a number of characteristics about the field of medicine that distinguish it from the typical market for goods and services. First, there is the question of consumer knowledge. Wright and Allen indicated that (1981):

The rapid proliferation of medical sub-specialities and technol- ogy has spawned relative ignorance in the consumer. Most sub- specialists prefer to receive referrals from general practitioners and internists, and are relatively unavailable to the population by self-referral. Many recent therapeutic and diagnostic modalities are unknown outside of the profession. The potential for advertising outside well-defined and standardized diagnostic and therapeutic modalities is exeedingly limited. Even a routine history and physical examination may be construed as anything from a cursory overview, taking approximately ten minutes or less, to an extensive process involving multiple blood, urine, and x-ray examinations.

Another factor that makes predicting the final outcome of physicians' advertising difficult is the effect of insurance and other forms of third-party payment. With the wide-spread prevalence of private health insurance plans and government programs that pick up the bill for doctors' services, there may exist little incentive to pay attention to price, making such services a "free good" (Business Week, 1981). In fact, price advertising might serve to drive prices up, if consumers view higher-priced doctors as better (Pa- rade, 1978). In this same vein, advertising might serve to induce competi-


tion on the basis of service and qualifications (needed or otherwise) at the expense of price.

Then there is the interdependence of supply and demand in the medical marketplace. In a normal competitive market, demand is relatively independent of supply, with each buyer able to make informed decisions about his purchases and suppliers. But the specialized nature of medical practice, the anxiety attached to health problems, and the urgency of many illnesses places much of the onus of such decisions in the hands of the physicians (Business Week, 1981). In this sort of environment, consumers might re- main loyal to a doctor, perceiving the risks of switching to be exceedingly high. If so, advertising might serve little purpose in inducing consumers to comparison shop and stimulating increased competition (Bloom, 1977).

EMPIRICAL RESEARCH

Despite its importance, relatively little empirical research has been done in the area of physicians' advertising. Ratchford and Andreasen examined consumers'decision-making processes with regard to various service pro- viders (i.e. hairdressers, plumbers, general practitioners, etc.). Subjects, who were asked " to imagine that they had just moved to a new community where they had never lived before . . ." , regarded the decision to choose a physician as important, complex, fairly subjective and devoid of much information (Ratchford and Andreasen, 1972).

Feldman and Spencer examined the influence of various sources of information, both nonpersonal and personal, on the selection of a physician by 182 new residents in a midwestern metropolitan area (1975). Not su- prisingly, these residents tended to rely on word-of-mouth in making the decision, given the lack of information from other sources. A majority of the new residents selected a doctor within their first month in the community and 90 percent had made the decision within four months.

Stiff measured consumer attitudes towards the general concept of physician advertising (1979). A majority of consumers in the study believed that doctors should advertise and they would not think less of a doctor who did. Forty-one percent felt that advertising would be of value to them, but few consumers felt that advertising would lower prices. On the basis of these figures, Stiff concluded that most respondents were favorable to doctors' advertising, but skeptical of its value.

In probably the most comprehensive empirical study, Kuehl and Ford (1977) used a sample of graduate students in a 3 x 3 Latin square design to study the significance of "practitioner attribute effects" (e.g. office hours,

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hospital affiliation, and years in practice), "information source effects" (primarily personal vs. non-personal), and "professional fee level effects." With a behavioral intentions measure as the dependent variable, only the information source effects were significant. In the case of attitudinal measures as the dependent vaiables, the information source effect was again the sole significant independent variable, but only for "professsionalism" and "trustworthiness," not for "competency" or "qualifications." From their research, Kuehl and Ford concluded that consumers are not knowledgeable enough about medical fees and skills to make an optimal judgement, imply- ing that consumer education programs would be neeeded before non-personal sources of information would be effective.

THIS STUDY

This investigation sought to measure the potential effects of physicians' advertising including price, competency, and service cues on consumers' attitudes and intentions.

Research Design

With a mailed questionnaire, subjects were presented with a doctor's ad (one of eight possibilities as explained below) and asked to evaluate it. Using the original Ratchford and Andreasen scenario approach, a cover letter asked consumers to "imagine they had just moved to a new community, where they had never lived before" and saw the accompanying advertisement in the newspaper (1972). This approach served to avoid situational effects under conditions of immediate emergency or extreme dissatisfaction with currently used practitioners.

The questionnaire was initially mailed to a random sample of one thousand residents of a medium sized SMSA in Wisconsin. A second mailing to the same thousand residents followed the first mailing by three weeks, increasing the total response rate to 31.3%

The eight possible ads represented the 8 cells of a 23 factorial ANOVA design (i.e. three factors, each with two levels). Figure 1 shows an ad with all three factors (price, competency, and service) at their high level. Again, each respondent was exposed to just one such ad and asked to respond to it.

Price appeared in the eight ads at two levels, $30 and $80 respectively, representing the range of prices quoted for a physical from general and family practitioners in the SMSA. These prices did not represent the same combination of tests, as there was little consensus among the doctors re-

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garding the exact specifications of a proper physical. This was not judged serious, however, since consumers often begin their information search for many goods and services with only a general idea of price in mind. Sub- sequent determination of a fair price then rests upon investigation of each brand and model's particular combination of features. Physicals were chosen as the source of the price cue here, because they represent a relatively discretionary purchase decision with which many respondents could be expected to have had some experience. The prices of office calls were also investigated, but the magnitude of the range was too small.

Service attributes similarly appeared at two levels in the ads. A low level of service was indicated by the presence of the doctor's phone number and address. A high level of service, as seen in Figure 1, was indicated by the availability of an after-hours phone number, extended office hours, house calls, immediate appointments for emergencies, and little waiting past time of appointment. These attributes were selected from earlier studies con- cerning sources of physician dissatisfaction (Kasteller, et. al., 1976; West and Blankenship, 1975; and Hulka, et. al., 1970).

As with price and service, competency was presented at two levels, low and high. The former was indicated by the mere presence of the title M.D., following the doctor's name. A high level of competency was indicated by identifying the doctor's medical college, place of residency training, university affiliation, and board certification. These attributes are in conform- ance with those recommended by various sources when choosing a physician (Cook, 1979; Business Week, 1981; and Brody, 1981).

The potential statistical significance of these three attributes at the levels described had been assessed in a pilot study with part-time MBA students. All had proved significant, although price only marginally so.

Dependent variables were chosen from other studies and initially totaled fifteen, although they clustered in the four general areas of professional competence, personal qualities, cost, and convenience (Hulka, et. al., 1970; Kasteller, et. al., 1976; and Kuehl and Ford, 1977).

Respondents' Profile

An analysis of respondents revealed a profile not that different from residents in the metropolitan area and the nation as a whole. The median age of the respondents was 39 vs. 28.3 for the SMSA and 30.0 for the nation (Sales & Marketing Management, 1981 and U.S. News and World Report, 1981). Thirty-five percent of the sample had completed high school, with almost 37% having completed college, figures above the na-


tional average (U.S. News and World Report, 1981). Seventy-two percent of respondents were married vs. the nationwide mean of approximately sixty-one percent. The median income of respondents was $21,000, right at that of the entire country (Sales & Marketing Management, 198 l). Forty- five percent of the sample had occupations in the professional, managerial, sales and clerical areas; twenty-four percent were skilled or semi-skilled workers; thirteen percent were housewives; and the remainder fell into the student, farmer and retired categories. Almost all of the respondents (98.7%) had a health care plan of some sort, the majority (83.4%) through their employer. Forty percent of the insured respondents had no deductible with their plan; the rest did, with eighty percent of these having a deductible of $100 or less. For sixty percent of the sample with a plan, all medical expenses were paid for; for the remainder, almost all plans picked up eighty percent of medical expenses. For physicals themselves, twenty-five percent of respondents had to pick up their own costs; for the remainder, part or all of the costs were covered (all costs for thirty-three percent of respondents). These figures for the extent of respondents' health care plan also do not differ significantly from that of the population as a whole. About 90% of the populace has some sort of medical coverage, and third party payments cover 91% of hospital costs and 63% of physicians' services (Business Week, 1982).

Analysis of respondent's questionnaires by date of return revealed no statistically significant differences, regarding the socioeconomic/demo- graphic characteristics of occupation, income, education, and age. These insignificant results precluded any extrapolation as to the profile of non- respondents.

RESULTS

Univariate Tests

Five dependent variables were chosen for analysis by univariate F-tests. These five, as indicated in Table 1, are "expensive/inexpensive," "convenient/inconvenient," "qualified/unqualified," "likely/unlikely to take a real interest in patients," and intentions. The first four employed a seven point semantic differential for measurement. Intentions to visit the advertised doctor were measured on an eleven point probability scale, ranging from "no chance, almost no chance (1 in 100)" to "certain, practically certain (99 in 100)." The four attitudinal variables were selected from the original fifteen on the basis of factor loadings from a varimax factor anal-

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ysis. They tend to replicate the findings of earlier studies (Hulka, et. al., 1970 and Kasteller, et. al., 1976). Intentions, a commonly used construct in advertising studies, was added to determine if any changes in cognitive structure occurred other than just attitudinal. Ideally, from the standpoint of the hierarchy of effects model, intentions would be assessed at a date later than attitudinal change, but available resources prevented this.

With "expensive/ inexpensive" as the dependent variable, Table 1 shows that the price cue ($30 vs. $80) was significant. Given the classic factorial design of the study (i.e. each subject sees just one ad), this is surprising, since it presumes respondents' pre-existing abilities to discriminate between a low and high price. As the vast majority of respondents were covered by health plans of one sort or another, a significant price effect was not expected. Neither using the insurer's portion of costs paid for a physical (none, part, or all) as a covariate, nor the presence of a deductible (yes or no) as a fourth independent variable, nor the percentage of co-insurance (all vs. less than 100%) in the same manner, revealed any results different form those reported in Table 1.

As further indicated in Table 1, there is a significant interaction effect for competency and service with "expensive/inexpensive" as the dependent variable. Taking the cell means of Table 2 and plotting them in Figure 2, a disordinal interaction effect is noted. This seems to indicate that, given a certain price level, whether a doctor is viewed as expensive or not depends on the particular combination of service and competency. With price at a low level and service fixed at a low level, increasing competency tends to make respondents view the doctor as more expensive. With price at a low level and service fixed at a high level, increasing competency tends to make respondents view the doctor as less expensive. Both of these tendencies are illustrated at the top of Figure 2. Much the same phenomena is noted when price is at a high level and service and competency levels are varied, although as depicted at the bottom of Figure 2, the effects are not quite as marked.

With "convenient/inconvenient" as the dependent variable, competency is significant at the .09 level, service is significant at beyond the .01 level, and price is insignificant. Examination of Table 2 shows that the higher service level and the higher level of competency both lead respondents to perceive the advertised doctor as more convenient. No interaction effects are significant here.


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With "qualified/unqualified" as the dependent variable, again both service and competency are significant and price is not. In both instances, Table 2 shows that higher levels of competency and service lead respondents to rate the doctor as more qualified. Again, no interaction effects are significant.

For "likely (unlikely) to take a real interest in patients," Table 1 shows price to be insignificant, while both competency and service are significant at beyond the .01 level. Apparently, respondents attribute a more caring attitude to a doctor at the higher levels of competency and service. A significant interaction effect between price and service also manifests itself here. This effect is portrayed in Figure 3, using the cell means of Table 2. At a given level of competency and with price fixed, moving from low service to high service improves the perception of the doctor as one more likely to care for his patients. This effect is particularly true with a high level of competency, where the interaction effect is disordinal.

Analysis using MANOVA (multivariate analysis of variance) was also conducted. As the results replicate that of the univariate tests above, in the interest of brevity, they are not reported here.

Personal Influences

As indicated in earlier studies, consumers seem to consider personal sources of information as more important in selecting a physician (Feldman and Spencer, 1975; Kuehl and Ford, 1977). A portion of this study was devoted to further studying the phenomenon. After exposure to the advertisement, subjects were asked to respond to the question, "In choosing a doctor, would you have more confidence in this advertisement or in the recommendation of a friend?" Response to this question is indicated at the end of Tables 1 and 2.

With confidence as the dependent variable, Table 1 shows that the three main effects of price, service and competency are all significant at the .07 level and beyond. The interaction between price and service is significant at the .10 level. These findings suggest that these cues can potentially affect consumers' reliance on personal sources of information. However, examination of Table 2 shows that all the cell means lie towards the bipolar extreme "more confidence in the recommendation for a friend." Evidently, while the above factors are significant, respondents still have a great deal more confidence in personal sources of information in choosing a doctor.


DISCUSSION

Before discussing the implications of this study, it is important to point out its limitations. First, there is the question of the representativeness of the sample. Responses were collected only from a medium-sized metropolitan area in Wisconsin, not the nation as a whole. Also, the response rate was thirty-one percent, raising the possibility that only the most interested replied to the mailed questionnaire. Yet, as indicated above, the profile of respondents was similar to that of American consumers in general and comparison of returns by date of reply implied that non-residents resembled respondents, at least with regard to occupation, income, education and age.

Second, subjects were asked to imagine they had just moved into a new community and were faced with selecting a new physician. This scenario approach precluded examining how likely consumers would be to change physicians in response to advertising. An existing satisfactory relationship with a doctor might severely limit the ability of advertising to induce comparison shopping.

Third, the price cue presented in the study was for a relatively discretionary decision. Under emergency conditions, consumers might not have the time nor the inclination to shop around. Again, these sorts of conditions would limit the potential effects of advertising.

As with any study of this sort, there is always the question of whether consumers will actually behave as they have indicated in response to attitudinal or even intentions questions. There is typically a less than perfect translation of these measures into actual purchase behavior.

Finally, unless a significant number of doctors choose to advertise, the whole question of potential effects may be nothing more than an academic exercise. While currently there may exist little incentive for doctors to advertise, a surplus of doctors is predicted by the end of the decade and this could change the impetus dramatically.

Despite these limitations, the study lends credence to those who would argue that advertising can have an impact in stimulating competition. Re- spondents here did demonstrate more favorable attitudes and intentions towards the doctor who advertised improved services, indicating the possibility of service competition. Similarly, they indicated preference for the doctor with greater credentials. This implies the potential for quality competition, although of course, it depends on whether the identified credentials actually translate into better care. With both these factors, it is interesting to note that they have an impact beyond the direct areas one might initially imagine. With convenience as the univariate dependent var-

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iable, service levels are significant, as might be expected, but altering the level of competency also has a significant effect. The same phenomenon is true with qualifications as the dependent variable. Competency expectedly has a statistically significant effect, and service does also. Evidently, consumer perceptions of physicians' attributes are interrelated; changes in cues have effects both direct and indirect. Certainly this is illustrated with the attribution construct,"likely to take a real interest in patients." As illustrated in Table 1, when competency and service levels are altered, perceptions of the doctor's likeliness to take an interest in patients are affected.

Since respondents had to recognize price cues as different on the basis of their prior experiences and since almost all had health insurance, the most suprising result was that price was significant. Perhaps consumers are more aware of economic cues in the health care areas than many imagine. Presenting objective inexpensive information on prices in advertisements may indeed stimulate price competition. And this study tends to indicate that "prestige pricing" may not be all that likely, at least for a physical. As Table 1 demonstrates, expense is not an attribute significantly affected when competency is systematically varied, nor when the same is done with service. That is, going from a low level of either competency or service to a high level does not significantly alter respondents' impressions of the expensiveness of the doctor. The fact that there is a significant interaction between service and competency, might tend to refute this conclusion, but examination of Figure 2 shows that in each instance, the low priced doctor is perceived to be less expensive than his higher priced counterpart, re- gardless of the level of service and competency. At a higher price, and with higher levels of service and competency, respondents view the doctor as less expensive, but still not as inexpensive as the doctor with a lower price and high levels of competency and service.

Yet, it is important not to overemphasize the potential effects of doctors' advertising. While price, competency and service had a significant effect on the reliance on personal sources of information, the cell means still indicated an overwhelming tendency to rely more heavily on friends for a recommendation. Obviously, personal sources of information could affect the impact of nonpersonal sources, such as advertising.

The results generated in this study provide only preliminary insights into the potential effects of physicians' advertising. To gain a finer picture of the elasticity of demand, a wider range of prices, service levels, and levels of competency would be appropriate. Price cues other than those for a physical should be researched. Service and competency could be broken down into individual components, rather than the clusters as found in this


study. With competency, for example, one could research individually the impact of years of experience, board certification, university affiliation, residency training, etc. Researchers could further delineate the impact of personal vs. nonpersonal information sources by varying the strength of a personal recommendation along with varying the levels of factors studied here. Alternative media sources could be researched: radio, television, direct mail, and "yellow pages," for example. Price, competency, and service cues could also be presented in a comparative advertising format. Yet other studies could be devoted to researching the effects of these same variables on the perceived risk of consumers.

Should doctor advertising become more prevalent, other avenues of investigation could be pursued. It would be interesting to ascertain the differ- ing levels of satisfaction of consumers who patronize advertising physicians vs. those who visit non-advertising ones. The records of local physicians' boards and state malpractice boards could be studied to determine if advertising has an effect on quality, as some critics would maintain. Whether advertising actually lowers prices or slows their increase in a market area appears a self-evident question. Advertising's effects on market entry could be researched by comparing the success of new physicians who advertise vs. those who don't. It would also seem obvious to determine what effects advertising has on consumer search behavior, both old and new residents of a community. Will consumers who already have a physician begin to shop around? Will new residents rely more on advertising and less on personal sources of information in selecting a physican? Of course, all these sug- gested studies assume that the Supreme Court's ruling holds firm and Congress does not rescind it through legislation.

REFERENCES

Bloom, Paul N. (1977), "Advertising the Professions: The Critical Issues, "Journal of Mar- keting, 41 (July), 103-110.

Brady, Jane (1981), "Take the Time to Choose a Doctor You Trust," The Kansas Ci~ Times, (Dec. 31), B-6

Camper, Diane and Jerrold K. Footlick (1975), "Discount Lawyers'?" Newsweek, 85 (June 30), 39.

Choudhury, Pravat (1981), "AMA Can't Prevent Doctors from Advertising, Court Rules," Marketing News, 14 (10), (February 6).

"Congress Fails to Vote on Stopgap Funds as Dissent Continues Over Jobs Issue, MX," Wall Street Journal, December 20, 1982.

Cook, Louise (1979), "Finding a Good Doctor is Complicated," Oshkosh Daily Northwestern, (Dec. 4), 30.

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Feldman, Sidney and Merlin Spencer (1975), "The Effect of Personal Influence in the Selec- tion of Consumer Services," in 1975 Combined Proceedings, Edward M. Mazze, ed., Chicago: American Marketing Association, 597-600.

"FTC Approves Rule Barring Ban on Eyeglass Ads," (1978), Wall Street Journal, (May 25), 4.

Green, Paul E. (1978), Analyzing Multivariate Data, Hinsdale: The Dryden Press, 170. "How to Pick a Good Hospital" (1981), Business Week, (April 27), 144-146. Hulka, Barbara S., Stephen J. Zyzanski, John C. Cassel, and Shirley J. Thompson (1970),

"Scale for the Measurement of Attitudes toward Physicians and Primary Medical Care," Medical Care, 8, (September-October), 429-436.

"Justices Clear Competitive Ads for Drug Prices," (1976), Wall Street Journal, (May 25), 3. Kasteller, Josephine, Robert L. Kane, Donna M. Olsen, and Constance Thetford (1976)

"Issues Underlying Prevalence of Doctor-Shopping Behavior," Journal of Health and Social Behavior, 17, (December), 328-339.

Kuehl, Philip G. and Gary T. Ford, "The Promotion of Medical and Legal Services: An Experimental Study" (1977), in Contemporao' Marketing Thought, 1977 Educators' Pro- ceedings, Barnett A. Greenberg and Danny N. Bellenger eds., Chicago: American Mar- keting Association, 39-44.

"Latest Profile of America's People" (1981), U.S. News & Worm Report, (September 14), 25-28.

Moskowitz, Dennis B. (1977), "The Great Ad Venture: The Legal Marketplace after Bates and O'Steen," Juris Doctor, 7 (8), September, 15.

Perreault, William D. Jr. and William R. Darden (1975), "Unequal Cell Sizes in Marketing Experiments: Use of the General Linear Hypothesis," Journal of Marketing Research, XII (August), 333-342.

Ratchford, Brian T. and Alan R. Andreasen (1972), "A Study of Consumer Perceptions of Decisions," in Advances in Consumer Behavior: Volume 1, Scott Ward and Peter L. Wright, eds. Boston: Association for Consumer Research, 283-286.

"Rx for Doctors," (1978), Time, (December 11), 72. "Should Doctors Advertise?" (1978), Parade, (June 11), 5. Stiff, Ronald (1979), "'Consumer Attitudes Toward Physician Advertising," in Proceedings:

Southern Marketing Association, Robert S. Franz, et. al. eds. "Survey of Buying Power" (1981), Sales and Marketing Management, 127 (July 27), C-223. "Surplus of Doctors Expected by 1990," (1981), Oshla~sh Daily Northwestern, (June 25), 3. "The Spiraling Costs of Health Care Rx: Competition" (1982), Business Week, (February

19), 211-213. "Why More Doctors Won't Mean Lower Bills," (1981), Business Week (May 11), 130, 135. Wright, Richard A. and Bruce H. Allen (1981), "Advertising in Medicine: Background,

Controversy, Conclusions," in The Changing Marketing Environment: New Theories and Applications, 1981 Educator's Conference Proceedings, Kenneth Bernhardt, et. al., eds., Chicago: American Marketing Association, 241-244.

ABOUTTHEAUTHOR

DR. R O N A L D B. M A R K S holds the r ank of Assoc ia t e Professor of Busi-

ness Admin i s t r a t i on at the Univers i ty of W i s c o n s i n - O s h k o s h and teaches

courses in Marke t Resea rch , Sel l ing and Sales M a n a g e m e n t and Mul t ivar-


iate Statistics. Dr. Marks received his M.B.A. from the University of Kansas and his Ph.D. from the University of Missouri. Prior to joining the University of Wisconsin, he worked for Burroughs Corporation in data processing sales and Superior Surgical Co. in hospital sales. Since joining the University of Wisconsin, Dr. Marks has published in the Journal of Retailing, the Journal of the Academy of Marketing Science, and the proceedings of various national and regional marketing associations. He has written a textbook for Allyn and Bacon, Inc. entitled Personal Selling: An Interactive Emphasis.

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Consumer response to physicians’ advertisements