“We heard about this idea of ‘transparency’ at a national conference, and we liked the idea of airing all of our dirty laundry,” said vice president of marketing Tom Teynah. “Clearly, trying to fix all of this was out of the question. But we thought, hey, let’s go with this honesty thing.”

The hospital says it’s too early to report overall results from the campaign, but anecdotal evidence is already piling up.

“I spoke with my 65-year-old neighbor the other day, right after she waited more than 2 hours to see her primary care physician,” said Teynah. “Boy, was she pissed. She said she wished she seen the advertising earlier, so clearly it’s making an impact on people.”

Sample campaign ad: “CEO/Pricks”

“Once we dug into this, we couldn’t believe what we uncovered,” said WiseBucks editor Joe Duhh. “Hospitals – believe it or not – are actually run like businesses. We were floored.”

Among the report’s findings:

• despite the fact that most hospitals are “non-profit,” they still must take in more money then they spend
• hospitals actually spend money to try and attract patients to their services (and in a ghastly finding, sometimes refer to them as “customers,” or worse, “consumers”)
• revenue from many hospital patients – particularly those with Medicare insurance – does not cover the cost of serving those patients
• shockingly, some hospitals have actual waterfalls

WiseBucks has won acclaim for its past investigating reporting, including:

“The moon is spherical: will this affect the tides?”
“While all squares are rectangles, not all rectangles are squares: the inside story.”
“Weather forecasters: could they be getting some predictions wrong?”

“For new clients who sign up with us before July 1, we’re offering to work for free for the life of the relationship,” said STD president David Pogilvy. “The margins are low – hell, they’re zero. But tough times call for tough action.”

According to Pogilvy, the agency will provide new clients with free marketing, PR, advertising and communications work, without any costs, for as long as the client remains active. The move comes in response to the ongoing budget cuts at hospital marketing departments, which were followed by discounts on services and offers of free consulting by other advertising and marketing firms.

“Others may offer a free audit, or $10,000 in free consulting,” said Pogilvy. “But we’ve decided why limit the discount? We want STD spread everywhere.”

Asked how current paying clients might respond to the promotion, Pogilvy said he wasn’t worried.

“Sure, they could quit, and then sign on as ‘new’ to receive free work forever,” he said. “But we have true symbiotic relationships with our clients. Why look for free help when you can pay us hundreds of thousands of dollars for a truly authentic experience? Uhhh…oh s***. This is off the record, right?”

“Good thing we weren’t actually riding all those times the picture was used,” joked Steve, a former barber. “We would have put a million miles on that bike!”

Steve and Sherry’s introduction into healthcare advertising began in 1973, when Steve’s brother, Brian, snapped a shot of the couple riding a tandem bike through Hyde Park in New York. Brian happened to work at a nearby hospital and brought the picture into work the following day, showing it around the department.

“Our corporate council really loved it, and we thought, why not use this to promote our hospital,” said Brian. “Who knew it would grow to become such a classic icon?”

Over the 35+ years since, Steve and Sherry have been photographed on more than 127 different tandem bikes and used in advertising for more than 1,400 hospitals and health systems. According to Steve, what started as something fun the couple did on the side turned into a lucrative business in the 1990s.

“That’s when it really took off, thanks to the availability of cheap stock photography over the Internet,” he said. “At that point, every hospital, system, clinic, doctor or veterinarian could use our photo. And it seemed like they did!”

Now independently wealthy, Steve and Sherry plan on traveling the world before settling down in their hometown of Miami, Florida.

“We probably could have kept going for years,” Sherry said. “But it felt like it was time to move on to something new.”

The current system creates misaligned incentives, inflating healthcare costs without improving the health of America. But paying by the inch, now there’s a common sense approach. Clearly, the taller the doctor, the more efficient the care – that’s been known for years. So why not go ahead and make the change, if it’s so obvious? Like anything else, moving such legislation through Congress will take time, and all interested parties will want to be heard from. The North American Short Anesthesiologist League (NASAL) will surely weigh in, as will The Measuring Tape Union, Lifts Across America, and Physicians for Top Hats. Buckle yourself in, we’re in for a bumpy ride.

- Ted Vesuvius, author, speaker, reformist