The ASA (Advertising Standards Agency) have taken their first step in prohibiting the sale of Cosmetic Surgery procedures on social deal sites.
The deal that has spurned action from the ASA was posted on Groupon back in May 2011 offered: “Today's deal in Manchester. Today's deal: £1,999 Instead of £5,000 for Cosmetic Surgery Such as Breast Augmentation and Rhinoplasty at Birkdale Clinic. View now. For £1,999. This deal is available until May 27, 2011 11:59 PM". Underneath, in a list of bullet points, it stated "Highlights: Choice of procedures include breast augmentation and Rhinoplasty.”
The deal was accompanied by the usual countdown style clock that ticked away the seconds until the deal ended and provoked a negative response from members of the public and aesthetic industry alike for its time pressure sales technique in such a serious decision. Despite the ever present ticking clock Groupon took a token gesture by hinting at the seriousness of the procedure but even trivialized this by offering up a humorous pun: “"Altering the physique needs a lot of careful consideration, a substantial amount of initial information and is better performed by someone who nose [sic] best” Consulting Room Members will remember how we featured this particular deal in our August Newsletter in which we questioned the ethics and morality behind the decision of quick draw invasive surgery. Our coverage of this issue had us inundated with correspondence from members of the industry who were outraged at the trivialization of serious medical procedures.
“Groupon is great for non-essential items such as days out, hotel stays, money off clothes etc but to advertise cosmetic surgery is wrong. How can a clinic expect to attract repeat business when they market to the discount hunters out there?”
“Prestigious brands such as BMW and Mercedes would never be discounted, so why should aesthetic clinics?”
“Groupon have cornered the market in people who are willing to risk their health for a cheap deal and then move onto the next.”
“These social bargain sites are catering to and attracting the wrong crowd into the usually selective aesthetic market.”
“It’s ideal for haircuts cheap restaurant meals and beauty treatments but for medical and surgical treatments...definitely NOT!!!”
“Cosmetic treatments need some explanation and consultation before patients/clients/customers agree to treatment. Buying from Groupon commits them to something that may be totally unsafe and unsuitable for them.”
“It is completely unethical for a medical treatment.”
We simultaneously ran a poll and discovered from the results the majority of respondents said they would not use Groupon and similar deal sites to advertise a treatment in their clinic, nor have they ever used this method in the past. When asked if, as a consumer, you use Groupon to purchase a cosmetic treatment 50% said No they wouldn’t, however, 26% said they were unsure and it would depend on the treatment being offered. Regardless of whether a clinic had used a social coupon in the past, an overwhelming 68% said they do not advocate the use of Groupon in the aesthetic industry.
The Independent Healthcare Advisory Services and a member of the public challenged whether the offer was irresponsible because it encouraged recipients to hurry into a life-changing decision to purchase cosmetic surgery in just a few hours.
In response to the challenge Groupon did not believe that the promotion encouraged a frivolous or rushed decision to purchase the voucher.
Groupon said the offer was available to buy for 24 hours only and the decision for that timeframe was made in collaboration with Birkdale Clinic, who provided the surgery. Groupon and Birkdale Clinic agreed on a maximum number of vouchers available to buy and they said it was possible that the offer could run again if the maximum number had not been met or if Birkdale Clinic decided to increase that number. Groupon believed that 24 hours would be an adequate amount of time to sell the agreed number of vouchers. They said this time limit was an indicator of their business model and was not indicative of pressure purchase tactics.
Groupon sent a follow-up e-mail to all consumers who had purchased the voucher which explained they had established a unique multi-stage booking process for the offer. The e-mail provided contact details for the clinic, gave consumers the opportunity to attend the clinic and meet with the staff, invited consumers to arrange a consultation with a co-ordinator to receive advice about procedures and to arrange a consultation with a surgeon and it explained that consumers were given a "cooling off" period in which to reconsider their decision to have a procedure. The e-mail also provided details of the surgeons available at the clinic and a link to check their registration with the General Medical Council. It further stated that consumers were entitled to a full refund at any point. Groupon said that as of the end of September, 48 out of 186 consumers had cancelled their vouchers – eight of whom had cancelled within seven days of buying the voucher.
Groupon believed that the tone of the information in the e-mail and on the website presented the offer in a factual and honest way and was not irresponsible.
However upon further assessment by the ASA the complaint was upheld.
“The ASA noted that Groupon had taken reasonable steps to ensure that once the voucher had been purchased, those consumers had the opportunity to contact the clinic for advice and they were also encouraged to seek independent medical advice about their intended procedure. We understood that the British Association for Aesthetic Plastic Surgeons (BAAPS) Marketing and Advertising Code of Ethics prohibited ads that offered discounts linked to a deadline date for booking appointments or other date-linked incentives. We also understood ads offering such discounts also went against the General Medical Council's good practice guide.
We noted that once the voucher had been purchased, consumers had a period of six months in which to redeem the voucher and had time and further opportunities to consider their decision before confirming their appointment with the clinic. However, we noted that those opportunities were not available without buying the voucher first.Whilst the ad made clear that the offer was available only to over 18s, we understood that it may have been sent to those who had not previously considered having cosmetic surgery. We considered the decision to undergo physically invasive procedures was one that required substantial consideration. We understood from BAAPS that multiple consultations were required before proceeding with a cosmetic surgery procedure, and that in some cases, candidates could be referred to a clinical psychologist to help assess their suitability for surgery. We understood that once the surgeon and candidate were satisfied that they were suitable for surgery, candidates were advised to wait a minimum of two further weeks before booking and going ahead with the procedure.
We noted consumers only had 24 hours in which to buy the voucher and because of that, we considered that consumers buying the voucher would have already financially and mentally committed themselves to going ahead with a procedure. We considered the very limited time in which consumers had to buy the voucher pressured consumers into making a decision to (to all intents and purposes) purchase cosmetic surgery. We therefore concluded the ad was irresponsible.
The ad breached CAP Code (Edition 12) rules 1.3 (Social responsibility). We also investigated the ad under CAP Code rule 12.3 (Medicines, medical devices, health related products and beauty products) but did not find it in breach.”
A representative from Groupon stated in reply: "We have moved quickly to address the ASA ruling and have already changed subsequent plastic surgery deals to extend the period they are available for," said a spokeswoman for Groupon, adding that the company has reviewed its process for offering such deals and has extended the expiration time limit to "at least three days" on average.
"Groupon endeavors to ensure that all of our advertised deals meet the highest possible standards and are both responsible and provide clear information for our customers," said the spokeswoman. "We are always striving to make the Groupon experience the best it can be and to ensure that the deals we offer are great value for our customers."
The ASA stated that the advert must not appear again in its current form.