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Consider the ‘source’ of nutritional supplements
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Dietary supplements are available from a variety of sources. Consumers buy them off the shelf at Wal-Mart and at their local supermarkets; they buy them from their neighbor who joined a multi-tiered marketing enterprise to earn extra money to buy a new boat; and from the neighborhood beautician who seems qualified because she is an “accredited” aesthetician. So why, when a physician makes nutritional supplements available to patients — and profits from it — does it raise eyebrows and ethical concerns?
Increasing numbers of consumers are purchasing nutritional supplements. Mounting reports of beneficial effects — anecdotal or not — are too appealing for the average person to ignore. But these dietary supplements are not benign compounds — and if taken in inappropriate amounts or in the presence of conflicting prescription pharmaceuticals, problems could arise. “So doesn’t it make sense to get preventive medical information from an MD rather than a retail clerk who might have a GED?,” asked Spencer P. Thornton, MD, FACS. Dr. Thornton is a past president of the American Society of Cataract and Refractive Surgery and more recently has been traveling the country speaking on the benefits of nutritional medicine.
Dispensing vs. recommending
Alcon Laboratories’ (Fort Worth, Texas) ICaps, Retoxil and ICaps-L (South America, Europe) and all of Bausch & Lomb’s (Claremont, Calif.) Ocuvite formulations are available at retail outlets, as well as in physicians’ offices. ScienceBased Health’s (Corte Madera, Calif.) nutritional supplements, however, are dispensed strictly by means of physicians. ScienceBased Health President and CEO R. Scot Hunter said, “There are a couple of ways that physicians can recommend or prescribe ScienceBased Health products.” ScienceBased Health uses the terms “recommend” and “prescribe” interchangeably, according to Mr. Hunter. “The majority of physicians in the ScienceBased Health program recommend the products to patients and then either in the office — usually by means of front-desk personnel — or over the phone with one of our customer care representatives, the patient places or fills the recommendation or prescription,” Mr. Hunter explained. ScienceBased Health then ships the product to the customer once per month, unless notified that it should be cancelled. “With products like ours, generally they are of long-term benefit, so they should become part of a life-long habit,” Mr. Hunter said.
“ScienceBased Health takes very seriously the effect that we can have on a doctor’s credibility, so we try to [emphasize] that we run our business in a way so that nothing we do will adversely affect the physician’s reputation,” Mr. Hunter said. “Before we even started our business, one of the things that we did was a state-by-state check of the laws, as well as reviewing where the American Medical Association stood on it and, more importantly, where the federal government stood on it. We found that our method of distribution is without legal restrictions in 48 of the 50 states. Montana and New Jersey do limit some aspects of the program,” he said.
“I believe there is a knee-jerk reaction on the part of most consumers in that if you get it from a doctor, then you are going to pay more, but because we are mindful of the doctor’s reputation, we have a real philosophy of value pricing. We try to show that if you went out to your local retail outlet and tried to duplicate our formula off the shelf, you would pay at least as much as you are paying ScienceBased Health and, according to our studies, you would be paying considerably more,” Mr. Hunter said.
Mixed feelings
California ophthalmologist Steven G. Pratt, MD, counsels all of his adult patients on the ocular benefits of good nutrition and sometimes recommends nutritional supplements, but does not dispense them. “I don’t sell supplements in my office at this point, but I don’t believe it’s unethical,” he said. “Doctors advertise for just about everything and that used to be considered unethical. I believe dispensing nutritional supplements is a decision that each physician has to decide for him or her self.”
Ophthalmologist and nutrition author Robert Abel Jr., MD, pointed out that the Academy of Dermatology and the Academy of Plastic Surgery have approved the practice of physicians dispensing nutritional supplements from their offices, providing that the prices are not exorbitant. “I have mixed feelings about it,” Dr. Abel said. “On the one hand, there’s a conflict of ethical interest when you are making a profit off of telling a patient what he or she should do. On the other hand, out of sight, out of mind — once they leave the office, they may not bother to buy the supplement and may lose out on something that can be a real benefit to them,” he said.
For Your Information:
- Spencer P. Thornton, MD, FACS, can be reached at 5070 Villa Crest Drive, Nashville, TN 37220; (615) 373-1236; fax: (615) 373-0333. Ocular Surgery News could not confirm whether or not Dr. Thornton has a direct financial interest in any of the products mentioned in this article or if he is a paid consultant for any companies mentioned.
- R. Scot Hunter can be reached at ScienceBased Health, 300 Tamal Plaza, Ste. 220, Corte Madera, CA 94925; (888) 472-0929; fax: (415) 927-0990; Web site: www.ScienceBasedHealth.com. Mr. Hunter is president and CEO of ScienceBased Health.
- Steven G. Pratt, MD, can be reached at 9850 Genessee Ave., Ste. 310, La Jolla, CA 92037-1205; (858) 457-3010; fax: (858) 457-0028. Dr. Pratt has no direct financial interest in any of the products mentioned in this article. He is a paid consultant for Alcon.
- Robert Abel Jr., MD, can be reached at Concord Plaza, Naamans Bldg., 3501 Silverside Road, Wilmington, DE 19810; (302) 477-2600; fax: (302) 477-2650. Dr. Abel has no direct financial interest in any of the products mentioned in this article, nor is he a paid consultant for any companies mentioned.