A Doctor Is a Brand and Should Be Treated As Such
Published by Matt February 19th, 2007 in Healthcared-ficient, originally uploaded by tamelyn
It’s an unpopular stance but I’m coming out in favor of doctors who pitch products. The Los Angeles Times ran an article recently about the topic and painted quite the negative picture:
When product sales generate a profit for doctors, this basic rule of medical ethics is jeopardized. Although treatment recommendations should be based solely on medical considerations and patient needs, a financial stake in the sale of a treatment can influence physicians’ decision-making. “When products are sold in a doctor’s office, the interest of the patient can be pushed into the background,”…
It’s short-sighted, though, to see docs as simply altruistic caregivers. I spoke with a retired surgeon today who claimed that in his working group absolute surgeries declined by 50% under managed care (HMOs) that paid practitioners under a salaried, rather than “transactional,” model. Regardless of whether treatment is service or product, economic incentives will play a role. In truth, reimbursement structures on standard service are pushing physicians to seek alternative means of revenue in order to simply maintain their income level.
Here’s how I look at it: a doctor is a brand and should be treated as such. The best doctors will maintain client loyalty by offering good service and recommending good products. What we need is information services that inform the physician selection process. Healthgrades, Vimo, and Revolution Health each have an offering but it’s early days in the healthcare transparency movement. If you’re an entrepreneur, I’d encourage you to look at this space and feel free to contact me about it. In the meantime, let’s not crack down on well-meaning physicians.
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While I agree that we have to respect the physician as a business person, this is a fine line. Physicians certainly should help push products to patients that need them, and I think they should disclose any significant incentives they get for pushing products.
The reason they are different is their trusted relationship with the patient. It is like a lawyer. You trust your lawyer to provide you with objective advice that is in your best interest. This might include recommending a company or service, but you don’t expect their judgement to be clouded by incentives.
George:
Thanks so much for dropping in and posting your thoughts. I wholeheartedly agree that “trusted relationship” demands careful treatment, there is a fine line here, and some docs abuse the system. In my experience, docs that do sell supplements are very careful about letting their patients know that they’ve done a ton of research (value-add service) and determined the best product for x is y. They’ll add that you’re welcome to buy on premises or from someone else or ignore altogether.
I do find it foolhardy to expect doctors not to respond to incentives. Perhaps it’s my economics degree talking, but I’d contend we all respond to incentives. The trick is to structure healthcare incentives in such a way that rewards physicians for optimal care - e.g. outcomes-based medicine.
Best,
Matt
I concur with George…it is a tricky slope when a physician begins endorsing a product, especially when it is a prescription product or service. In fact, Medicare agrees, and does not allow a physician to refer a patient to a service (like a laboratory, etc) that he or she has a financial interest in. The same should be true with other products. With new health savings accounts, people like you and I will need to have discussions with our physicians that include how much will this cost me now that I pay the first dollar? At least the physician owes the patient full disclosure….I think that at a time with trust between physicians, patients and hospitals is at an all time low, now is not the time to complicate it with financial intermingling.
Passionate about the patient’s rights,
Candace