So I'm flipping my way through The New York Times, reading about Haiti this morning. (Though in local media, of course, the real action is happening online, thanks in large part to Ms. Montanez's efforts at That's Church.) And then I come across this ad -- occupying about half of page A-25:

In case you can't read it, the copy there reads (in part):

UPMC is one of the most experienced centers in the world -- with more than 1,200 procedures completed -- for the next generation of endoscopic skull base surgery. Over the last decade, UPMC head and neck surgeons, neurosurgeons, and ophthalmic surgeons have collaborated to develop techniques for accessing deep-seated brain tumors through patients' nasal passages ...

And it goes on like that. (I'd re-type more, but as described this medical procedure reminds me of a recurring nightmare from childhood.) You get the idea: UPMC is pitching itself to the readers of The New York Times as a center for cutting-edge medicine. 

I know what you're thinking. I've already gotten e-mails making the same argument: "UPMC doesn't have money to operate a hospital in Braddock, but they DO have the money to advertise in New York? It's an outrage, I say!"

Yes, yes. But considering UPMC has operations in places like Qatar and Ireland, we're past being surprised by this sort of thing, aren't we? Not to mention that advertising in New York media is hardly a novel strategy for the health-care behemoth.

What interests me more is this: This the first UPMC ad I've seen in a long time that actually advertises a medical service. Most of the UPMC ads I see -- the ones made for local consumption -- are all about what a hell of a bunch of guys the people at UPMC are. And how they are, like, building a new Pittsburgh ... a city at the confluence of aspirations and hard work ... where bridges are built from yesterday to tomorrow ... and on and on. 

Or there are those "UPMC Minute" ads, which in their own way are every bit as annoying. Sure, eventually the ad gets around to acknowledging that -- since we were just talking about it -- UPMC does have a cardiac-care center that you may wish to learn more about. But that always comes after a bunch of blather pretending that these health tips are for our own good.

You'd think UPMC would use a more highbrow approach in the Times than it deploys for, say, commercials wedged between Wheel of Fortune and Jeopardy. But the Times ad is actually notably direct. None of this bullshit about bridges and rivers here. Just "Our doctors are really good. You should check them out."

I really think we'd all be a lot happier -- UPMC included -- if their local TV ads were all more like that too. But maybe that seems too crass: If they had to hawk their wares to us, it would be implying that we were customers, rather than dependents who subsist on their good will. Customers, see, have power. They can always go somewhere else. 

Hence the approach in The New York Times. With the exception of the occasional alt-weekly editor who stumbles across a copy of the paper, the Times reader who sees this ad is likely to be affluent, with a good health plan and lots options. This is an audience that can take UPMC or leave it. They can pick and choose from medical centers all over the country, even the world. 

Most Pittsburghers, of course, don't have that option. So UPMC sure isn't going to pimp itself out to us. As the local healthcare market's 800 pound gorilla, it doesn't have to. So instead of getting us to choose UPMC, the ads try to console us about the fact that UPMC is, increasingly, our only choice. 

"We've chosen each other," the ads seem to say. "You're just like us, and we're just like you. So let's all admire the skyline together, shall we?"

I'm not saying I want to turn Jeffrey Romoff into Earl Scheib ("I'll remove any spleen for just $1,995!"). But I might feel better about UPMC if they didn't seem so sure of being the only game in town. And seeing this Times ad-- with its blatant appeal to customers who aren't dependent on it -- is a reminder of what things would be like if "choice" actually existed in healthcare.