BOGO: Healthcare by smartphone

The smartphone has helped drive the astronomical growth of the group coupon market, since notifications of daily coupons, also known as "daily deal alerts," are sent directly to the phone and the codes can be redeemed directly off of the device.

It is questionable as to whether these deals for healthcare are on par with healthcare services that are paid through insurance or full price out of pocket.

"I would have to say that it depends on what service is being offered," says Linda MacDonald Glenn, JD, LLM, assistant professor in the Department of Medical Education, Alden March Bioethics Institute, Albany (NY) Medical Center. "Discounted plastic surgery, for example, depends on the provider's track record and providing that there are no unethical incentives, such as 'buy one tummy tuck and get a second surgery free,' encouraging patients to undergo combinations of procedures that could greatly increase the risk of complications."

Coupons and group rates can also discourage an individual from checking the doctor. Lisa Anderson-Shaw, DPH, MA, MSN, clinical director, Clinical Ethics Consult Service, assistant clinical professor, University of Illinois Medical Center, Chicago, says, "The coupon is what gets them in the door, so to speak. It is often that consumers look up a provider they are not familiar with on the internet to check out individual feedback. Those that do not are no different than when insurance coverage changes and they now have to pick a provider from a list, never having seen this provider before. The consumer does have a right to trust that any licensed provider is competent to do what they are advertising that they can do."

If a track record of a provider is poor, and that provider offers discounts to reach more patients, people might not check out the provider. However, it really is no different than going to a licensed tradesman. "In many ways we all take a chance with a provider or a plumber, if we don't check out the person's credentials, their feedback on web sites, or talk to folks who may have used their services in the past," says Anderson-Shaw. "There is no guarantee that the quality of any provider, with or without a coupon or discount, is less or greater than par."

The fear is that patients will seek out treatment from places that give them the best deal regardless of the actual quality of the service.


For more information, contact:

  • Lisa Anderson-Shaw, DPH, MA, MSN, Clinical Director, Clinical Ethics Consult Service, Assistant Clinical Professor, University of Illinois Medical Center, Chicago. E-mail:
  • Linda MacDonald Glenn, JD, LLM, Assistant Professor, Department of Medical Education, Alden March Bioethics Institute, Albany Medical Center, Albany, NY. E-mail:
  • Matthew K. Wynia, MD, MPH, FACP, Director, The Institute for Ethics and Center for Patient Safety American Medical Association, Chicago. E-mail:
  • Web: World Health Organization's health system rankings