Virtual Mentor. January 2005, Volume 7, Number 1.
Case 6.3: Office Sales—Supplemental Income
Selling any health-related or non-health-related products from the office risks demeaning the profession of medicine. Entrepreneurial financial endeavors are not unethical in and of themselves, but, when they are exercised within the patient-physician relationship, they can create a conflict between the physician's financial interest and the welfare of the patient. Under such circumstances there is serious concern that patients are being exploited. Physicians should take steps to minimize financial conflicts of this type. The following Opinions identify guidelines for the sale of both health-related and non-health-related products from the physician's office.
It is important for physicians to limit in-office sales to those that serve the immediate and pressing needs of patients. As with prescription products, if a product is available at a local pharmacy, physicians should avoid selling it from their offices.
In-office sales of health-related products that are available only through physicians and offer a unique benefit to patient health raise particular concerns. Since patients are unable to purchase an equivalent product elsewhere, physicians have a monopoly on the market, and patients are captive consumers. Exclusive arrangements such as these are troublesome because they force patients either to purchase the product from their physician or to forgo the recommended treatment. If a physician strongly believes that a patient needs the product that is available only through physician-distributorship, then he or she should encourage the manufacturer to make the product accessible through alternative existing structures such as pharmacies.
Should it be deemed necessary to sell a health-related product from a physicians office, see also Opinion 8.03, "Conflicts of Interest Guidelines;" Opinion 8.032, "Conflict of Interest: Physician Ownership of Medical Facilities:" Opinion 3.01, "Nonscientific Practitioners;" Opinion 8.20, "Invalid Medical Treatments."
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