Practice-based sales risk reducing physicians to cosmetics salespeople

Regarding "Office-based sales hinge on patient's best interests" (Column, Oct. 2): I read with interest this commentary by Michael H. Gold, MD, of Nashville, Tenn.

As a practicing dermatologist, I am concerned about the office-based sales of some of my colleagues. A walk through many cosmetically-oriented offices or a quick perusal of their Web sites will reveal that some physicians are selling much more than health-related products, and much of what is sold has questionable evidence of effectiveness. While most cosmeceutical products are physiologically harmless, they do cause harm to the pocketbooks of our patients and to the reputation of our specialty.

The sale of these products in a physician's office implies a clinical or scientific rationale for their use. Obviously there is a financial incentive to take advantage of that perception.

While my current practice has no office-based sales, I do recognize a potential need for certain physician-supplied products. These sales should be limited to those products that have demonstrated clinical merit and that are not easily obtained elsewhere. To do otherwise is to unethically use our position as physicians to inappropriately market products to patients.

Dr. Gold describes us, in part, as "skin care professionals." To me, this puts us in the same category as aestheticians and department store sales representatives. The sales of makeup, age-defying cosmeceuticals, and particularly eyeliners turn patients into clients and physicians into salespeople. We must think long and hard about how this influences the public perception of our specialty and, more importantly, always consider what is best for our patients.

Daniel D. Bennett, MD, Temple, Texas

Note: This item originally appeared at http://www.ama-assn.org/amednews/2006/11/06/edlt1106.htm.