Looking to boost its profile in faraway places, the University of Pittsburgh Medical Center is buying ads in national newspapers and magazines to compete with other major health systems across the country for patients, physicians and even financial donors.

TNS Media Intelligence, a New York-based firm that tracks ad spending, says the health system spent more than $1 million on national advertising during the first six months of 2005, an increase compared with the $290,000 spent during all of 2004 on national ads. In previous years, the health system didn't advertise in national publications, said Sandra Danoff, interim vice president for communications at UPMC.

Ad spending is on the rise overall, Ms. Danoff added. While the health system budgeted $5 million in total ad spending during the fiscal year that ended June 2005, that number has doubled for fiscal 2006 and includes $1.8 million in national advertising.

Ads for UPMC and Children's Hospital of Pittsburgh have cropped up recently everywhere from the New York Times and Wall Street Journal to the in-flight magazines on several major airlines.

The advertising push befits an organization that now has more than $5 billion in revenue and competes on a national stage, Ms. Danoff said. UPMC reported that it attracted about 5,000 patients from beyond its 29 county service area to hospitals in Oakland during fiscal 2004.

"This is the first year that we've really looked at advertising as part of a national marketing strategy, and this is the visibility aspect," Ms. Danoff said. "People tend to think of us as being this hometown Pittsburgh organization, but the reality is we do compete in a national market."

The other big players in the local health care market -- Highmark Inc. and West Penn Allegheny Health System -- haven't engaged in national advertising. During 2004, Highmark spent $7.4 million on local advertising, according to TNS Media Intelligence, while West Penn Allegheny spent $286,000.

UPMC spent $4.1 million on ads of all types in 2004 according to TNS Media Intelligence. Ms. Danoff noted that UPMC's increased ad spending during the current fiscal year will come to just one quarter of 1 percent of its total revenue.

"So, yes, we're up, but the numbers are still very, very small," she said.

Children's Hospital has run ads in USA Today and the Wall Street Journal touting the hospital's expertise in organ transplant surgeries. That's an important message to send not just to consumers in need but also to physicians who refer patients for advanced care, said Dean Walters, spokesman for the hospital.

Pediatric hospitals fiercely compete in a national marketplace for doctors in certain specialties, Mr. Walters said, and having a hospital with name recognition helps with recruitment. That's why the hospital bought ads in the September edition of US Airways' in-flight magazine -- Children's knew that pediatricians from across the country would be flying the airline to Washington, D.C., for the annual meeting of the American Academy of Pediatrics.

UPMC also has advertised in the in-flight magazines of Southwest, United, American and Northwest airlines, among others, said Ms. Danoff. The strategy is to reach "mobile decision makers when they have a chance to read," she said, primarily on carriers that fly from Pittsburgh or throughout the Northeast.

While some UPMC ads run in the national editions of newspapers, many run in only regional editions that circulate in the Northeast corridor, Ms. Danoff said.

Advertising in regional editions makes sense if the goal is to "strengthen the magnet" and draw patients from a wider geographic area, said Betsy Gelb, professor of marketing and entrepreneurship at the Bauer College of Business at the University of Houston. Hospitals that publish an ad in the New York Times often will buy reprints and distribute copies to physicians who refer patients to the medical center, said Mrs. Gelb, who founded the Institute for Health Care Marketing.

"They're trying to say, 'We're playing on a national stage,' " she said. "Of course, Johns Hopkins doesn't have to take out an ad to tell you that."

Beginning in November 2004, Johns Hopkins Health System spent $2 million on a six-month ad campaign that started in New York City with the goal of winning philanthropic donations. The health system is in the process of raising $270 million to build two new clinical towers, said Gary Stephenson, spokesman for the Baltimore-based system.

UPMC is not alone among academic medical centers that advertise outside their hometowns. Several years ago, the Cleveland Clinic promoted its care for heart patients with billboards in Pittsburgh.

Whether it's a local or national audience that's being targeted, health care marketing prompts unease from some medical professionals.

Research published in March in the Archives of Internal Medicine studied the content of ads placed by UPMC and the 16 other medical centers named to U.S. News & World Report's honor roll of best hospitals in 2002. Unlike advertising to attract clinical research participants, ads to attract patients are not subjected to formal assessments for balance and straightforwardness, the researchers noted.

Many of the ads studied relied on emotional appeals and trumpeted potential benefits without saying much about possible harms. The results prompted Dr. Robin J. Larson, lead author of the study and a researcher at the Veterans Affairs Medical Center in White River Junction, Vt., to conclude that many ads seemed to place the best interests of the medical centers before the interests of patients.

But Ms. Danoff said she didn't view the two as mutually exclusive.

"I would argue that information about the availability of services, and alternatives, benefits patients," she said.