Rather, the new talk is about opening up the walls of hospital waiting rooms and corridors (of public and private facilities) to advertisers. Advertisers of what? Pharmaceuticals and other health care-related products, would be the obvious assumption, but in some areas of the world, waiting patients are just as apt to find missives for household cleaning products or men's haberdashery.

"Companies fear linking their products with the image of pain and suffering that is deep-rooted in people's perception of hospitals," said Lodolo D'Oria, the head of Bates Healthworld in the Wall Street Journal (May 8, 2001).

Mr. D'Oria's allusion to the psychological nuances of brand association, which are absolutely central to successful brand warfare, are particularly poignant given the nature of this medium. Though hospitals are where people go to get better, many often don't feel well when in them. Doesn't it follow that an advertisement for a new line of shoes could be lost on someone waiting to have their infected toe treated? Even the wait for a routine physical can stir up feelings of anxiousness, thus rendering one oblivious to wall advertisements, or worse, establishing a negative association with the product being promoted.

While the concept has yet to truly take root in Italy, many hospitals in Canada have been generating revenue through the marketing of products extraneous to the health care industry for some time.

Ottawa Hospital has been operating a mini-shopping mall, one largely run by volunteers, for nearly twenty years now. Profits from the shops, which include a bookstore, a flower shop, a card shop and a baby store, are invested in the hospital, as is the revenue generated from leasing space to Second Cup, a Canadian franchise coffee shop.

Cyndy DeGiusti, chief of public affairs for Toronto's Hospital For Sick Children, explained that though that hospital has not implemented wall advertising, it has "pushed the envelope" in terms of the retail space it provides to outside franchises. The hospital, which is the largest provider of children's care in Canada, opened its first store in 1996. Today, employees and visitors can frequent a Burger King, Tim Horton's (a coffee store franchise), Shopper's Drug Mart (a national drug store chain), the Body Shop (a specialty knick-knack store), and the contemporary kingpin of the retail branding world, a Starbucks.

"That's probably more than some people are comfortable with," opined DeGiusti. "But when it comes to the actual patient-care area of the hospital, we don't even allow donor companies to use corporate logos – we simply allow them to use names.

"Because this is a Children's Hospital, there are people who believe that we shouldn't be promoting, even in a very indirect manner. The hospital actually owns the franchises in most cases, or at least is the landlord. Between the profits on our franchises and the rent, the hospital is able to raise CAN$6M (US$3.9M) a year from the retail operations. That gives us a significant amount of flexibility. The money goes back into our research institute or to buy special pieces of equipment that we wouldn't be able to afford otherwise."

Ms. DeGiusti says there have been no formal complaints to the presence of the franchises. The "minor" criticism, usually in the form of an offhand comment, has been tolerable given the rate of profit, particularly in light of the crunch on Canada's publicly-funded hospital system.

"We desperately need ways to increase our revenues. This is a fairly harmless way of doing that. We have 5,000 staff members coming and going through the hospital, and for them the stores are a great convenience. And most families would agree that they are convenient as well.

"We're not ashamed of what we're doing," added Ms. DeGiusti. "Our goal is to add three or four more franchises in the next two years."

The tight margins under which Canada's hospitals operate facilitated Zoom Media's push to bring inside wall advertising into hospitals over three years ago. A Montreal-based marketing firm, Zoom Media began installing dozens of private and public service ads on the inside walls of nearly 100 hospitals and health clinics by February 1998.

Claude Breault, a communication manager with the firm, explained that the number of health care facilities in which they have placed ads has grown to 195. "So far, it has gone very well," says Mr. Breault. "It has surpassed our original expectations."

Because the concept is still in its burgeoning stage, the future potential revenue for hospitals is difficult to gauge, according to Breault.

"Right now, the advertising hasn't generated huge dollars. But it's going well. It takes a little time for a new medium to grow on advertisers. The first two or three years are usually spent building the credibility of the medium. We are at the point where we have reached the credibility needed to grow further."

Most of the initial criticism for Zoom's new venture came from the press. Breault says it was feared advertisers would have carte blanche on where the advertisements were placed. But the advertisements are restricted from operating rooms and other treatment areas. "We have to be mindful that we are dealing with hospitals," said Breault. "The advertisements only appear in waiting rooms and other high traffic areas. The hospitals also reserve the right to refuse any of the advertising."

As far as the effectiveness of the ads are concerned, Breault reports that all of Zoom's initial clients have continued to place ads, indicating their faith in the effectiveness of the medium.

Ironically, in the United States, the world's capital of commercialization, the possibility of marketers vying for consumers via the hospital waiting room has yet to be broached. Maternity wards often send new mothers off with a gift basket, sometimes with samples of baby formula, but outside of that tradition, US marketers have never had hospitals for inroads to direct-to-consumer advertising.

But could US consumers someday see wall advertisements lining the corridors of their local hospitals? Rick Wade, senior vice president of the American Hospital Association, says never say never.

"I don't know of anything that comes close to wall advertisements, except what we're seeing in Rhode Island, where a new children's hospital was built with the Hasbro name attached to it. But that was the result of philanthropy.

He’s not ruling it out though: "I have no doubt that somebody somewhere will try this, because in this country, somebody tries something at least once."

Perhaps the surprising part of all this is that it hasn’t happened sooner. After all, where else could one find an audience so captive.    

[2-Jul-2001]