It's time to dip into the H&HN Daily mailbag and see what's on our readers' minds.

Marty Stempniak blogged last week on Texas Health Resources' big transparency announcement.

Ron Hammerle, chairman of Health Resources, commented:
An excellent beginning. Watch next for warranties and guarantees on a limited range of medical and surgical procedures, as healthcare enters a new competitive phase of accountability.

Linda Galindo added this:
Hospital and health system board members take note. This is what accountability and transparency looks like. Is your hospital CEO on track with this type of reporting? This is accountable leadership. It is also the key to excellence. Great article, great effort.

Managing Editor Bill Santamour has been writing a fair amount recently on hospital nutrition, including this blog about hospitals upgrading their own menus.

Health and wellness expert Toni Sicola sent in this comment:
I agree that how it's framed makes a difference, however to equate a hospital choosing a healthy menu to a "Big Brother" state (regardless of how it's framed) is ridiculous. The mission statement of our hospital is "Caring, Healing, Teaching, Serving All." I'm not sure how french fries heals or serves anyone. I'm also wondering how it's not considered a direct conflict of interest by all hospitals everywhere to serve junk food to the community they serve. Actions have consequences. No individual lives in a vacuum where others won't suffer the consequences of his/her actions. Disregarding your health hurts everyone in the community who pays taxes or medical insurance if you then seek care for your ailing health (as everyone has the right to do). If you want to eat french fries, go do it in a place that's not trying to provide you or your loved ones with cardiovascular, obesity, diabetic, or cancer care. Don't be upset that the hospital that's working to save the life of your loved one (or your own) doesn't want to serve you garbage.

And this from Davyd Levkovich:
Very legitimate concern. I am an immigrant, and, working in health care in the US, I found a much stronger, and still growing obsession with "patient satisfaction" tangibly above medical necessities. I agree: it is a must that a patient feels better after an encounter with medical professional; however, health literacy, or rather illiteracy, should be taken into equation.

Regular columnist David Ollier Weber penned a provocative column late last month on the $1.5 billion that hospitals spend annually on advertising and what they get for it.

The column drew this response from Stewart Gandolf:
As CEO of a health care marketing agency, here are my 2 cents. First, I agree that branded advertising is difficult to truly measure, and can sometimes be a waste of money. However, as the last few sentences of the article indicate, that doesn't mean "marketing doesn't work." At our firm, almost everything we do is based on scientific marketing principles, and most of our advertising and online strategies are designed to generate new patient inquiries. Those inquiries are precisely tracked, and return on investment can therefore be calculated. Today, savvier hospitals and even doctors don't mind investing $500,000 in marketing (for example) when it generates $5 million in trackable revenue. In terms of the skeptical doctor wishing for the old days of no advertising, marketing has been legal since the Supreme Court case Bates V. State Bar of Arizona in 1977. There is nothing new about a (now rapidly shrinking) percentage of doctors begrudging marketing, but a reversal of a Supreme Court case seems highly unlikely. The competitive pressures are now enormous, far higher than the artificially sheltered marketplace of the 1970s and before. Lastly, as Chris Bevelo's comments indicate, advertising and marketing are not synonymous. Marketing includes many of the tactics listed above (community events, online risk assessments, etc.) which can prove a hospital is a cut above the rest, not just claim it.

And this from Bill Stiles:

There is a polemical slight of hand going on here. Hospitals and doctors compromising their integrity by endorsing products is very different than using advertising as a thoughtful, intentional and appropriate element of marketing strategy.

The amounts invested by health systems in advertising pale in comparison to other industries. In fact, the lack of effectiveness for many health care marketers is linked to the fact they spend too little to implement a fully engaged marketing program, and rely too much on advertising to do the heavy lifting.

Yep, there's some misguided advertising out there, but the solution is not a magical mystery return to the good old days. One way forward is to observe what works really well among more sophisticated marketers in other sectors, and adapt it with sensitivity to the unique needs and higher ethical standards health care services demand.

As always, we value your input. Please write to us in the comment box below each article.