What is "Ethical Treatment Marketing"?

"Ethical" is fast becoming word-of-the-year in the addiction treatment marketing space.

(Hey - we use it too;)

Ever since The Verge and the New York Times exposed the shadiness that passed-for-normal in treatment marketing, those who don't sell referrals or outright lie to people have had an easy differentiator.


But try finding a "how-to" on ethical marketing - especially one not written either at a third-grade reading level, or in legalese.

"Essentially, treatment center marketing should in no way interfere with an individual's ability to efficiently and effectively find the care they need," wrote one.

"Additionally, an important aspect of ethical marketing also means adherence to 42 CFR Part 2 and HIPAA guidelines and ensuring that patient privacy and peace of mind are at all times protected."

Great. Thanks for clearing-that-up.

Journalistic sources are also mostly unreliable, conflating unethical practices like patient-brokering with stuff that's boilerplate for any Fortune 500, like paying a lot for clicks on Google Adwords.

That's left many treatment centers in murky water as they try to sort the good-from-the-ugly.

"We don't pay for referrals," one center CEO told me last year, in response to an offer for branded internet ads.

But reputable treatment centers need a way to reach qualified people who need their help more-than-ever, as referrals slacken.

All-of-which inspired me to write a plain-english, no-B.S. guide to what's fair-game in treatment marketing, what's pushing-the-boundaries, and what's over-the-line.

Straight-Talk Ethical Guideline One - Don't Imply You're Local if You're Not

Three varietals of shady marketing brought down the wrath of the Times and John Oliver, and got the industry banned on Google Adwords.

The first was "sending patients out of state".

As one blog put it...

"It should be clear to prospective clients and referents where a treatment center facility is physically located, what types of treatment they provide, what insurance they accept and other basic information. This should be clear at all times and in all forms of communication. There have been cases, for example, of centers using websites and web advertising to make it appear that they offer help in many cities and states when, in fact, their facility is located in only one city or state."

I start with "sending patients out-of-state" because it's probably the least-legible guideline.

After-all, if you have prospective clients in Spokane, Washington, what's wrong with advertising there, even if you're located in Costa Mesa?

Answer: nothing.

But here's where it gets a little squishy: Google Adwords is keyword-based - obviously, as anybody's who's seen the sponsored results after fat-fingering a search term knows.


Is it ethical to run banner ads for a So-Cal treatment center to people Boise? Of course.

How about if you run Google ads that display when people search "alcohol rehab boise". That's shadier. A searcher with an explicitly local intent expects his/her search results to be local.

Even if you represent your true location all over your site, should you be running out-of-state ads to local keywords?

Shadier-still, many marketers were actively representing themselves as local when they weren't.

It's my belief that the keyword basis of the Google Adwords platform was the genesis of the fake-local issue.

How to make sure you're 100% "white hat"?

Put your address right atop your website, as many of my clients do.

And if you're using Adwords, maybe don't bid for local keywords unless you're actually local to those searchers.

Oh, and while-we're-at-it...

Straight-Talk Ethical Guideline Two - Don't Buy Leads from a Third-Party Who Represents Themselves as a Treatment Center

"Pay-per-lead" still exists in treatment marketing.

Instead of running ads on behalf of client centers, pay-per-lead marketers collect leads themselves, then sell those to partner centers.

Certain flavors of pay-per-lead are illegal, and marketers who do it practice a legal "soft-shoe" to color-within-the-lines.


false front.jpg

Representing yourself as a third-party, offering a referral to a treatment center, and disclosing that you have financial relationships with the centers to-whom-you're-referring.

Representing yourself as an impartial third-party, who will make a recommendation for the "most clinically appropriate" treatment center, then selling the leads to centers with whom you have financial relationships.

Representing yourself as a center (even though you're a third-party lead-aggregator), often a local center (see above), then selling the leads off to the highest bidders.

All slightly shady, right?

The alternative, of course, is branded advertising.

Branded advertising just means you run ads as yourself, so potential patients know what they're getting start-to-finish.

Straight-Talk Ethical Guideline Three - Don't Pay for Referrals

The center-owner who mistook branded advertising for paying-for-referrals was confused, but he wasn't wrong about paying-for-referrals.

Treatment centers traditionally got a great many of their intakes via referral from "upstream" medical and psychological professionals.

Offing money for those referrals would obviously create a version of the same conflict-of-interest I discussed above, except way-worse, because people trust their medical professionals, a lot more than they trust Google, to make clinically-appropriate recommendations.

Here's the thing about paying for referrals, though: it's bright-line illegal, and hardly anybody does it.

So just, continue to...not do it.

Straight-Talk Ethical Guideline Four - Don't Run Afoul of HIPAA

Also, don't use patient testimonials without their permission, or discuss them by-name with colleagues except as outlined by HIPAA.

But addiction professionals know about HIPAA.

So what does that leave us?

It's pretty straightforward, right?

Don't lie...

...avoid conflicts-of-interests, online and off...

...and hew-to-HIPAA.

I suspect part of the reason for the mass-confusion was the shift to the pay-per-lead model in treatment marketing.

As long as you go branded, and tell the truth, however, there's little to worry about.