Television is a powerful medium that can be used by hospitals and physicians for both marketing and public service announcements. Hospitals frequently use TV advertising as part of their marketing strategy to build awareness of their services, increase referrals, announce new facilities or services, attract staff, and enhance their image. The perceived advantages of TV advertising over other forms of advertising include the ability of TV to combine audio and visual information, the ability to reach a large audience over a short period of time, and the prestige associated with TV advertising that often improves the image and credibility of the advertiser. Many factors determine whether a hospital uses TV advertising. For example, a hospital that is located in a large city where local competitors are using TV advertising often feel the need to participate as well in order to maintain a competitive edge. An institution that has a history of previous successful TV advertising campaigns will likely continue. The effectiveness of a TV advertising campaign can be measured by surveys that measure consumer awareness of hospitals, and by calls to a specific phone number to which patients are asked to call to request appointments. There is little published data on the effectiveness of TV advertising by hospitals. However, a study by the Texas Tech University in 1999 evaluated the effectiveness of hospitals sponsoring of local broadcast news health care segments and found that when surveyed, a majority of viewers could not name the sponsor or the topic of the news report.1 Despite the results of this study, the impression of many hospitals is that TV is one of the most effective media for advertising. A recent TV advertising campaign by the University of Chicago hospitals resulted in a doubling of the number of phone calls to the Cardiac Center. The costs of TV advertising include production costs and media time. Ad production costs vary depending on the sophistication, production quality, and technical requirements. On average, a TV commercial costs $300,000 to develop, produce, and edit. The cost of media time varies depending on the market and when the ad is shown. A 30-second TV advertisement in Chicago ranges from $1,300 to $9,500, depending on the popularity of the program during which the ad appears. Other cities such as New York and Los Angeles can be more expensive. The cost of a 30-second national TV advertisement ranges from $90,000 for a program that attracts a relatively small viewing audience to over $1,000,000 for an ad that is shown during the Super Bowl. Effective TV advertising often requires a consistent TV presence over time. The University of Chicago Hospitals has achieved broad awareness in the Chicagoland area by using TV advertising consistently. Other hospitals in Chicago that have had advertising budgets that vary widely from year to year have been less successful. It is not clear how much hospitals spend on TV advertising, but a large hospital in Chicago was recently reported to be planning to spend $5,000,000 in total advertising. Public Service Announcements (PSAs) are another mechanism by which TV can be used by physicians to gain exposure and to increase awareness of specific public health issues. TV stations were previously required by the Federal Communications Commission to devote a certain percentage of their broadcasting time to PSAs. Although this is no longer mandated, TV stations continue to air PSAs as part of their community service missions. The content of the PSAs is chosen by the stations based on material that is sent to them. The Guidant Foundation is a nonprofit organization that is affiliated with the Guidant Corporation and provides financial support for charitable and educational programs. It has taken advantage of TV public service announcements to increase awareness of sudden cardiac death and congestive heart failure. During the Scientific Sessions of the North American Society of Pacing and Electrophysiology in San Diego in 2002, one-hundred physicians were videotaped while delivering a prepared 30-second message regarding the issue of sudden death or congestive heart failure. Each videotape was made into a PSA and was distributed to 5 different TV stations that were in the viewing area of the electrophysiologist who made the recording. The Guidant Foundation funded the costs of the production and distribution, but physicians were not reimbursed for their participation. During the first 6 months of the campaign, these PSAs reached 30 million viewers and were aired in 10 of the top 50 markets including Boston, Detroit, Los Angeles, New York and Philadelphia. Overall, these announcements have been well received and the Guidant Foundation plans to continue the campaign. However, physicians who are involved in these activities must be cautious. A well-intentioned PSA involving a physician can occasionally be viewed negatively by hospital administrators, who are currently very sensitive to potential conflicts of interest. Promoting the coverage of clinical trials by the news networks is an indirect way for physicians to use television to gain exposure. Resources from the device or pharmaceutical companies can be used to increase the likelihood and quality of TV news coverage. For example, last year the sponsor of the MADIT II Trial, Guidant Corporation, sent MADIT II Media Kits to the 5 major TV networks (ABC, NBC, CBS, FOX and CNN) shortly after the results of the MADIT II Trial were delivered by Dr. Arthur Moss at the Scientific Sessions of the American College of Cardiology. Every network except FOX reported on the mortality reduction found with prophylactic defibrillator therapy in the MADIT II Trial. This TV news coverage resulted in accurate reporting of the results of an important clinical trial to approximately 8 million American viewers. In summary, TV can be used effectively as part of an effective marketing strategy for hospitals and physicians. TV Public Service Announcements and promotion of TV news coverage of clinical trial results provide an inexpensive opportunity for physicians to improve community awareness of important public health issues and at the same time receive useful local TV exposure.