CAMLAW: Complementary and Alternative Medicine Law Blog : Complementary, Alternative, & Integrative Medicine Law, Regulation, Ethics & Policy (Alternative and Complementary Medicine, Medical Spa Information, Holistic Health Attorney, and Legal Resources)

In 1998, the AMA adopted an “Ethical Position Against In-Office Sales of Health-Related Products:”[1]

In-office sale of health-related products by physicians presents a financial conflict of interest, risks placing undue pressure on the patient, and threatens to erode patient trust and the primary obligation of physicians to serve the interest of their patients before their own. When these items offer some health-related benefits the physician's influence over the sale is amplified and makes it even more necessary to place limits on such activities.

1. Physicians who do sell health related products from their offices should not sell any health-related good whose claims of benefit lack scientific validity. Physicians should rely on peer-reviewed literature and other unbiased scientific sources that review evidence in a sound, systematic fashion when judging the efficaciousness of the product.

2. Physicians who sell health-related products from their offices should follow these guidelines to limit their conflicts of interest minimize the risk of brand endorsement, and ensure a focus on benefits to patients.

a). Physicians may distribute health-related products to their patients free of charge or at cost, in order to make useful products readily available to their patients. When health-related products are offered free or at cost, it removes the elements of personal gain and financial conflicts of interest that may interfere, or appear to interfere, with the physician's independent medical judgment.

b). Except under certain circumstances, such as those described in Opinion 8.032, “Conflict of Interest: Physician Ownership of Medical Facilities,” physicians should not sell a health-related good when patients can obtain a product that offers the same medical benefit at a local pharmacy or health-products store.

3. Physicians should not participate in exclusive distributorship of health-related products, in which the products are available only through physicians' offices and for which product there is no comparable alternative available at a local pharmacy or health-products store. Physicians should manufacturers to make their products more widely accessible to patients.

In addition, the Model Guidelines for the Use of Complementary and Alternative Therapies in Medical Practice issued by the State Federation of Medical Boards state:

6. Sale of Goods from Physician Offices
Due to the potential for patient exploitation, physicians should not sell, rent or lease health-related products
or engage in exclusive distributorships and/or personal branding;
• Physicians should provide a disclosure statement with the sale of any goods, informing patients of
their financial interest; and
• Physicians may distribute products to patients free of charge or at cost in order to make products
readily available.
• Exceptions should be made for the sale of durable medical goods essential to the patient’s care, as
well as nonhealth-related goods associated with a charitable or service organization. [Language
on the sale of goods from physician offices is contained in the report of the Special Committee on
Professional Conduct and Ethics as adopted in April 2000.]