When doctors sell products

These situations blur the boundaries between a therapeutic relationship and a commercial relationship. A patient may feel pressured to purchase; financial gain may distort a doctor’s judgement of the patient’s best interests; and the trust between doctor and patient may be undermined.

Honesty and transparency

The Medical Board’s Code of Conduct covers conflicts of interest (10.12) and financial and commercial dealings (10.13), including:

A conflict of interest in medical practice arises when a doctor, entrusted with acting in the interests of a patient, also has financial, professional or personal interests, or relationships with third parties, which may affect their care of the patient… They require identification, careful consideration, appropriate disclosure and accountability.

…

Doctors must be honest and transparent in financial arrangements with patients. Good medical practice involves:

... declaring to your patients your professional and financial interest in any product you might endorse or sell from your practice, and not making an unjustifiable profit from the sale or endorsement.

It would be reasonable to inform patients of your profit verbally if discussing a product, and in writing as part of an online product listing. An unjustifiable profit might involve a price above the recommended retail price, if one exists. Also, inform the patient where else they can purchase the product. If the product is part of a patient’s clinical treatment, document this in the medical records.

A Queensland GP was reprimanded and had conditions imposed on her registration in 2019 after she failed to disclose a conflict of interest for recommending a particular product and involving a patient in a marketing scheme.

Safety and efficacy

Before selling products to patients:

• satisfy yourself that any scientific claims are authoritative (e.g., from peer-reviewed journals)
• consult the literature independently rather than rely on the manufacturer’s claims
• inform the patient if there is little scientific evidence for the product, and document this in the medical records
• be alert to potential drug interactions
• stay up to date with the product’s scheduling status with the Therapeutic Goods Administration (TGA).

Advertising

• Making claims of a scientific nature must be accompanied by appropriate evidence for such claims – see Ahpra’s Acceptable evidence in health advertising.
• If a product you’re selling is a ‘therapeutic good’ (as opposed to cosmetic) or is advertised using claims of a therapeutic nature, advertising must comply with therapeutic goods regulation – see the TGA’s Advertising hub.
• You should be familiar with the Australian Competition and Consumer Commission’s information for medical professionals about the Competition and Consumer Act.

Insurance coverage

Seek advice as to whether you need product liability insurance. Your Professional Indemnity or Practice Indemnity Policy may have an exclusion in relation to indemnity for matters arising out of supply of goods and products.

Reference:

1.Parker MH, Wardle JL & Stewart CL (2011) Medical merchants: conflict of interest, product sales and notifiable conduct. MJA 194(1):34-37: mja.com.au/journal/2011/194/1/medical-merchants-conflict-interest-office-product-sales-and-notifiable-conduct

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