Why do hospitals advertise?

I know why drug companies advertise. They have products, and diagnoses, to sell. They have doctors to influence and patients to recruit. But why do hospitals advertise? I've decided to do a little lay research, now that I have this incredible tool, the Net.

I sent an email a while back to Seattle's Children's Hospital, saying I hoped they weren't spending too much of the donated money they ask for each year on their expensively produced TV commericals and the expensive TV station time to run them. I got a reply from a marketing person who said, in effect, that hospitals must advertise because the marketplace has become so competitive. This, from our city's only children's medical center.

I remember the first time I started seeing TV spots for hospitals. I thought, why do they want to entice me to the hospital? Like I'm looking for something to do on a Friday night and hey, let's go that fun hospital. You only go to the hospital when you have to. I don't want to go to the hospital.

Things, I've learned, are more complex than that. Managed care has made the hospital--or its associated clinic--the place you establish a relationship with a doctor. I guess my mind is out of date. Doctors can't advertise--unethical. Hospitals can. And hospital advertising is just like advertising for, say, insurance companies, or even department stores. And they can be quite competitive. Aggressive, even. Check out this coverage in the Detroit News, last spring, when one hospital suggested, on billboards, that another hospital might be pushing speed over quality in its emergency room ads. Emergency room ads. I don't want to end up in anybody's emergency room.

Also last spring, a study of print ads placed by some of the nation's top-rated academic medical centers, appearing in Archives of Internal Medicine, questioned the techniques of the advertising:

The study of newspaper ads by 17 top-rated university medical centers highlights the conflict between serving public health and making money, the researchers said.

Some ads, especially those touting specific services, might create a sense of need in otherwise healthy patients and “seem to put the financial interests of the academic medical center ahead of the best interests of the patients,” they said.

Here's the entire story, from AP via MSNBC. The studiers said they chose teaching institutions' advertising to study because:

As leading sources for specialized medical care, training and innovation, academic medical centers were selected “because we thought they would be the best-case scenario,” Larson said. “We thought if we find problems there, we would assume that they’re only worse” at community hospitals.

There's been a lot of discussion on this issue. These examples are from the first page of my Answers.com and Google searches. Maybe I'll discover everything's just fine, and I should just shut up and enjoy the many benefits of the free market. Except, I don't think you should ask advertising people to sell health care. You're going to get headlines in ads from first-rate medical centers like, "We do Botox." (From the AIM study.)

Today, I saw a TV commercial about how great doctors are, from the American Medical Association. Why does the AMA feel they have to sell me on doctors? Who else am I going to go see when I want help with my health? Wal-Mart Medical Center?