Deciding whether to recommend Avastin or Lucentis raises ethical issues. Should the public health consequences of using a far more expensive drug trump what the doctor thinks is best for the individual patient?
Good ethics and good business don’t have to be in conflict. Ophthalmologists shouldn’t resort to requiring their patients to buy contact lenses in-house; instead, they should focus on expanding their skill set and providing personalized service.
Asymmetry in knowledge and power between (1) physicians and patients and (2) physician educators and their students creates a climate for possible abuse in both sets of relationships.