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Just hours after the government approved a medicated patch for depression, an e-mail went out offering reporters the opportunity to speak with a "doc in private practice stunned at FDA approval of depression patch."

A decade ago, the idea of doctors and dentists marketing themselves would have been shunned by the medical community. Now, driven by higher costs and inspired by direct-to-consumer pharmaceutical ads, doctors are hiring publicists to increase business.

"There has to be this admission that being in medicine is also a business," said Rudy Svezia, president of DocGrow, a medical marketing firm in Englewood, N.J.

He said his clientele increased sharply about five years ago, as remuneration from insurance companies decreased. Still, there's plenty of resistance to the idea.

"If Dr. Jones is willing to at least investigate what marketing is about and deal with some professional sneering, he will see that he'll do better business than the guy down the street," Svezia said.

Medicine is becoming more of a consumer-driven business, said Barbara Kahn, professor of marketing at the Wharton School of the University of Pennsylvania. Patients demand the drugs they saw advertised in newspapers and magazines and on television, and they want to be treated by the doctor they saw on the news.

But although a dentist knows the difference between a crown and a cavity, he probably never learned how to grow his practice. That's where public-relations professionals step in.

David Edenbaum is a periodontist who uses a laser to fix people's teeth, a practice that eliminates drills and needles. He wanted more people to know about it.

"My wife is a Realtor, and she hands out my card," said Edenbaum. "While word-of-mouth is great, I wasn't sure how to get the message out further."

He contacted Levy Jacobs Marketing, a public-relations firm in Marlton, N.J. The company placed an article about Edenbaum in SJ Magazine - a regional magazine, also a Levy Jacobs client, that covers South Jersey - and is writing a newsletter for the practice's 4,000 clients. The article brought in about 30 new patients, Edenbaum said.

Five years ago, the firm had one dentist on its roster, said Maury Z. Levy. Today, it has "a least a half a dozen dentists and a couple of doctors."

Until 1980, the American Medical Association reviewed physician ads until the Federal Trade Commission told it to stop. Now the group simply tells doctors to make sure the information they send out is "truthful and accurate," said an AMA spokesman.

A 1989 article in the Journal of Advertising said doctors felt ads harmed the image of the profession. Even today, when they approach agencies, often their first concern is that the campaign appear professional.

"David is a very humble guy," Jacobs said, "but he's doing all these cool things with the laser and with teeth whitening, and just wasn't telling his own patients."

Those who do seek professional help are often loath to discuss it. For example, Braverman, who practices in New York, sent a message through his public-relations firm that he was going to pass on being interviewed for this story.

Zachary Gerut, a plastic surgeon in Hewlett, N.Y., hired a publicist to get the word out about a face-lift procedure he created using a local anesthetic. He draws the line between a tasteful media campaign and taking out an ad.

"My insides would shrivel if I ever saw my ad," he said, adding that the idea was not to increase business. "I needed to publicize the procedure as mine, that I developed, so that it wouldn't be stolen."

A doctor promoting a book might pay $9,000 for a publicist to set up phone interviews with radio stations in 10 U.S. markets, said Leigh Fazzina, who represents health-care publicists at the Public Relations Society of America.

Winslow Murdoch started working with a public-relations firm after joining a "boutique" medical practice five years ago. All his patients pay an additional $2,000 a year for no-wait appointments, personalized care, and constant access. Murdoch lost 80 percent of his business when he switched. Using direct mailings and speaking to groups, he saw his practice grow from 125 to 250 patients.

"With this kind of practice, I'm like a doctor that's just starting out, and I have to have my name out there and my face out there, and I strive for the kind of quality that I couldn't do before," he said.

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