Facebook legal and regulatory advertising compliance by specialist orthodontic practices: a cross-sectional survey

Background: Healthcare providers are increasingly using social media websites such as Facebook to advertise their services. The Australian Health Practitioner Regulation Agency guidance on the advertising of healthcare is based on the National Law in Australia and prohibits advertising that is contrary to the patient's best interests. Aim: To determine the legal and regulatory advertising compliance of the Facebook pages of specialist orthodontic practices in Australia. Methods: The Facebook pages of specialist orthodontic practices were identified following a systematic search strategy. The content uploaded to each 'eligible' page between March 2019 and February 2020 was reviewed with regard to five specific domains of prohibited advertising. Cronbach's Alpha Test was used to determine intra-rater agreement. Results: The Facebook pages of 147 specialist orthodontist practices in Australia, representing 288 specialist orthodontists, satisfied inclusion criteria. Most Facebook pages (82.3%) breached the Law in one or more domains. The mean number (standard deviation) of domains breached was 1.65 (1.3), range 0-5. Non-compliance regarding 'the use of testimonials' (76.9%) and 'information that was likely to create unrealistic expectations of orthodontic treatment' (40.8%) were the domains most commonly contravened. All five domains were breached in 5.4% of practice Facebook pages. Intra-rater scores were strong, ranging from 0.84 to 0.94. Conclusions: Compliance of the Facebook pages of specialist orthodontic practices in Australia with legal and regulatory advertisement requirements is poor. Greater awareness of the relevant obligations by specialist orthodontists responsible for their practice Facebook content is necessary to ensure that their advertising is not liable to charges of legal and/or professional misconduct.