Your patient is checking out at the dermatologist’s office. Copay? Check. Next appointment? Check. Can we show you our skincare supplements? Come again?
For some physicians, the prospect of selling vitamins, supplements, ointments, or skincare products in the office may make sense: It’s easy to explain the benefits of a product when it’s on hand, and it’s convenient for patients to buy what their doctor recommends — on the way out the door.
As for the ethics of in-office sales, however, the AMA’s ethics code is pretty clear: “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 undermine the primary obligation of physicians to serve the interests of their patients before their own.”
How this is interpreted in doctors’ offices around the country, however, differs depending on who you talk to.
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“If a product is stocked, it should solve a real care-plan problem, not become a second revenue stream driving the visit,” said Zach Cohen, MD, a double board-certified anesthesiologist and chronic pain physician in San Diego, California. “My rule would be to keep the product list narrow, evidence-based, and tied to a diagnosis or treatment goal. If I wouldn’t recommend it to my own parent without profit involved, it doesn’t belong on the shelf.”
In other words, selling products in-office should be something that’s done with intention and without profit incentive.
“I think offering thoughtfully selected supplements or products in the office can be very valuable when it is done with transparency, intention, and patient education at the center,” said Dendy Engelman, MD, a double board-certified cosmetic dermatologist and Mohs surgeon at the Shafer Clinic in New York City. “Dermatology does not start and finish with a prescription. Taking care of your body with the right products is important for extending the work we do in the office.”
For others, the ability to demonstrate how a product should be used is a valuable reason for selling that product in the office.
“Giving a parent a brochure isn’t as helpful as opening up an eczema cream, for example, and doing a demo of how much to put on a child’s skin,” said Lauren Provini, MD, a double-certified dermatologist and pediatric dermatologist in Madison, Connecticut. “It’s helpful for them [patients] to be able to buy something while they’re here, and I’ve found that they’re more likely to use something I recommend if they don’t have to make an extra trip to the store and pick it up.”
A Doctor’s Seal of Approval Can Help Counter Online Claims
Getting recommendations from your trusted dermatologist who understands your skin needs — instead of getting tips from a TikTok influencer — is yet another reason it might help to have a robust inventory of products in the office, Engelman said.
Though critics might argue that doctors are free to recommend all the products they want without actually selling them.
“Patients are exposed to so many claims online and it can be difficult to know what’s credible, what’s worth investing in, and what may not be appropriate for their skin or health,” Engelman said. “When a product is recommended or available through a physician’s office, there is often an added layer of trust because patients know it has been evaluated through a medical lens.”
And depending on the specialty, there are so many brands crowding the market, and that can render confusion among patients.
“The OTC skincare market is complicated,” said Provini, who is also an assistant clinical professor of dermatology at Yale School of Medicine.
“One brand might make several different products, and often there are subtle but important differences between them.”
However, patients are savvy consumers these days, and for some, a doctor’s office hawking products may raise red flags. Why these products? Why this brand? What does the doctor get out of it? There’s enough of a hard sell at med spas and boutiques without listening to a spiel about supplements at your derm or gyn appointment, some patients might think.
Patient perception matters.
Vetting Products Is Critical for Trust
If you’re going to sell products in your office, every item you keep on hand needs to be backed by science.
“These products should be clinically relevant and aligned with the physician’s standard of care, not simply sold because it’s trendy or commercially appealing,” Engelman said.
“I’m very transparent that I’m not being paid by any company to endorse their product and that my price is the same as they’d pay on Amazon,” Provini said. “I’m a pediatric dermatologist, yes, but I’m also the mom of a daughter with eczema who has tried lots and lots of products. I only stock ones that I’d use on my own child.”
In the end, it’s critical for anything you sell in your office to relate to your specialty and the health issues you treat, said Raymond Douglas, MD, PhD, a board-certified oculoplastic surgeon and researcher at Cedars-Sinai Hospital in Los Angeles.
“The problem doctors can have when they start stocking products is the absence of a clinical story connecting those products to the care they're already delivering,” he said. “Without that thread, patients treat the office like a health food store. I've watched colleagues add supplements and then pull everything within a year — for exactly that reason.”
Douglas’ advice for any physician reading this: “If you're stocking products because your sales rep has a commission, stop,” he warns. “If you're stocking products because years of disease-specific research tells you exactly what your patients need between appointments, that's medicine.”
The experts cited in this article had no relevant disclosures.
Lambeth Hochwald is a New York City-based journalist who covers health, relationships, trends, and issues of importance to women. She’s also a longtime professor at New York University’s Arthur L. Carter Journalism Institute.