South Carolina Board of Medical Examiners

LLR-Board of Medical Examiners

Approved by the Board: July 17-18, 2000 Board meeting

Service Area: Medical

Subject: Sale of Health Related Products in Physicians' Offices

NOTICE:

In accordance with the S.C. Code Ann. Section 1-23-40, notice is hereby given that the South Carolina Board of Medical Examiners has adopted the following statement regarding the sale by South Carolina physicians of health-related products in physicians' offices as guidance for licensed physicians in the practice of medicine under the South Carolina Medical Practice Act and the Principles of Medical Ethics, as adopted by the Board.

POLICY:

"Health-related products" are any products that, according to the manufacturer or distributor, benefit health. "Selling" refers to the activity of dispensing items that are provided from the physician's office in exchange for money and includes the activity of endorsing a product that the patient may order or purchase elsewhere that results in direct remuneration for the physician. This Policy does not apply to the sale of prescription items.

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 interests of their patients before their own.

1. Physicians who choose to sell health-related products from their offices should not sell a product 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 and reliable fashion.
2. Because of the risk of patient exploitation and the potential to demean the profession of medicine, physicians who choose to sell health-related products from the office must take steps to minimize financial conflicts of interest utilizing the following guidelines:

1. In general, physicians should limit sales to products that serve the immediate and pressing needs of their patients. For example, if traveling to the closest pharmacy would in some way jeopardize the welfare of a patient with a broken leg requiring crutches, then it may be appropriate to provide the product from the physician's office.
2. 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 helps ensure removal of the elements of personal gain and financial conflicts of interest.

3. Physicians must disclose fully the nature of their financial arrangement with a manufacturer or supplier to sell health-related products. Disclosure includes informing patients of financial interests as well as availability of the product elsewhere. Disclosure can be accomplished through face-to-face communication, or by posting an easily understandable written notification in a prominent location in the office. Physicians should, upon request, provide patients with understandable literature in addressing the risks, benefits and limits regarding the health-related product.

4. Physicians should not participate in exclusive distributorships of health-related products that are available only through physicians' offices. Physicians should encourage manufacturers to make products of established benefit more widely accessible to patients than exclusive distribution mechanisms allow.