DOCTORS’ OFFICES: Product-Peddling Raises New Concerns
Complaining that their salaries are being squeezed by managed care, more and more doctors are becoming entrepreneurs, today's New York Times reports as it examines patients', professional groups' and some doctors' increasing discomfort with the "trend toward merchandising in medical offices." Physicians now sell everything from "prescription eyeglasses and contact lenses to vitamins and nutritional supplements to products that have nothing to do with health care, like mops and magazine subscriptions." While professional societies and state medical boards have no specific bans on doctors selling directly to patients, they are "increasingly concerned about the ethics of the practice" and are scrambling to draft policies. The American Medical Association has "long held that it is a generally permissible part of medical practice," but in 1997 the organization urged its members to stick to health-related products. Dr. Robert Tenery, head of the American Medical Association's Council on Ethical and Judicial Affairs, said that the AMA rejected an outright ban on the practice because it recognized that while there were complaints, "there were also a lot of physicians out there who are now depending a great deal on income coming from selling products to their patients." Specifically, doctors say the extra income helps offset the cuts from managed care. But American Association of Health Plans spokesperson Donald White pointed out that doctors' income "has continued to rise despite managed care," up to an average of nearly $200,000 before taxes versus just under $120,000 in 1986. Other doctors note that selling from their offices allows them to make products they believe in -- especially alternative medicine products like herbal supplements -- available to their patients. However, Dr. Donald Saunders Jr., a professor of medicine and bioethicist at the University of South Carolina, said, "It creates a financial conflict of interest, and it demeans the practice of medicine. I think this kind of thing really wounds the trust bond between the physician and the patient" (Zuger, 3/30).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.