Office-based sales hinge on the patient's best interests

Ethics Forum. Oct. 2, 2006.

Scenario: When is it appropriate to sell nonprescription items to patients?

During the past 15 years the nonprescription skin care business has expanded rapidly, as can be seen by walking into any pharmacy or looking at the cosmetic counter of any department store. The industry has been a topic of debate among physicians.

Reply:

Sales of skin care products have reached billions of dollars per year, and it seems to me that dermatologists and plastic surgeons -- those physicians who spend their time dealing with skin care concerns and issues -- are in the best position to recommend the most appropriate skin care product or regimen to their patients.

I refer to this as a "one-stop shopping" platform for dermatologists and plastic surgeons. We understand skin better than any other group and, if dispensing of nonprescription skin care products is done ethically, I find no reason why the practice -- which has become standard practice in the majority of dermatologic and plastic surgery offices across the United States -- should not continue to grow and to thrive. Nevertheless, there are strong advocates of and vocal opponents to the concept of dispensing products from clinical offices.

A look at the guidelines of the professional societies reveals a range of opinions about office-based sales. The American Medical Association's Code of Ethics discourages sales of nonhealth-related products but allows physicians to sell health-related products when there is scientific evidence of their effectiveness; the patient is not coerced; physicians disclose their financial interests in product sales to patients and tell them whether the product is available elsewhere; and physicians are not taking part in exclusive distributorships.