Yes I'm fat, but you're corrupt.
June 16, 2011 12:13 PM   Subscribe

Is it legal for a doctor in California to be hawking weight loss and dietary supplements out of her office?

Just went to see a cardiologist about some intermittent chest pain. While I was in the waiting room, one of the staff came out and turned on a TV. At first I didn't notice what was playing, but gradually it dawned on me that it was a looped ad for some weight loss program called "Ideal Protein." During the course of the visit, I noticed ads for this stuff everywhere. Although my heart was apparently fine (and she never did tell me what was causing the chest pain), the doctor harangued me about losing weight, even before actually examining me.

The relevant facts: I'm 37 y.o., male, 6'3", 220 lbs. That's a BMI of 27.5. Some of that's muscle... but not all. So I could stand to lose some weight. And while my blood pressure was low when at rest, it did jump up to 170/80 while doing a stress test. So I'm totally willing to believe that carrying extra weight is is risky for me.

But I also felt that there was a lot of emphasis in this practice on shaming people about weight, and these ads were everywhere. When I told her that I thought this presented a conflict of interest, she said that it did not, because "This is just one of the products we sell." And they do sell it, right there in the office -- I overheard a member of the staff explaining the product to another patient, and there are "Certificates of Excellence" from the Ideal Protein company celebrating her accomplishments as a "Consultant."

(And for sure it's not just the "Ideal Protein" program, either -- she also told me she had just been talking to another patient about "detoxifying his body with whole foods and green plants." Also there was a whole display cabinet in the lobby filled with supplements.)

So my question, as I'm sure you've guessed, is: is this legal? Does it violate any kind of medical ethics regulation? Can I lodge a complaint with the medical board? I find it irritating and creepy... but is there anything I can do about it?
posted by thehandsomecamel to Law & Government (9 answers total)
Actually not quite sure since she does announce she is a consultant for the company. She's revealing her ties with them. A lot of docs are paid in focus groups, editorial boards, or hell even receive funding from pharma co. to do peer-reviewed studies so I think the shade is grey.

So I'm not sure if you have a case. But it doesn't hurt to complain and let the professionals sort it out.

Creepy, uncomfortable doctor is reason enough to change to a new physician. Why she is hawking things that aren't FDA-approved gives me a red flag that morally she isn't serving the best interest of her patients.
posted by stormpooper at 12:25 PM on June 16, 2011 [1 favorite]

I don't know about the legal end but it seems to me that from an ethical standpoint she is taking advantage of her position and trust placed in her to exploit peoples fear of unhealthiness and fatness for her own profit.

Did you get referral to her? If so I would complain to them. There are also online doctor rating services you could put a complaint on and if I were you I wouldn't hesitate to do so.
posted by SpaceWarp13 at 12:30 PM on June 16, 2011 [1 favorite]

This is probably legal. I wouldn't bother with it.

But... if a doctor is advertising the whole "detoxifying" thing, you'd do best to never visit them again.
posted by Threeway Handshake at 12:34 PM on June 16, 2011

Best answer: Here is the relevant section from the American Medical Association's Code of Ethics ("Opinion 8.063 - Sale of Health-Related Products from Physicians' Offices"). I have highlighted some key passages for you below:

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.

(1) Physicians who choose to sell health-related products from their offices should not sell any health-related products whose claims of benefit lack scientific validity. When judging the efficacy of a product, 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 their offices must take steps to minimize their financial conflicts of interest. The following guidelines apply:

(a) 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 the patient (eg, forcing a patient with a broken leg to travel to a local pharmacy for crutches), then it may be appropriate to provide the product from the physician’s office. These conditions are explained in more detail in the Council’s Opinion 8.06, "Prescribing and Dispensing Drugs and Devices," and are analogous to situations that constitute exceptions to the permissibility of self-referral.

(b) Physicians may distribute other 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 to ensure removal of the elements of personal gain and financial conflicts of interest that may interfere, or appear to interfere, with the physician’s independent medical judgment.

(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 about the availability of the product or other equivalent products elsewhere. Disclosure can be accomplished through face-to-face communication or by posting an easily understandable written notification in a prominent location that is accessible by all patients in the office. In addition, physicians should, upon request, provide patients with understandable literature that relies on scientific standards in addressing the risks, benefits, and limits of knowledge regarding the health-related product.

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

Your physician does appear to have a clear conflict of interest, which could serve as a basis for a complaint to the Medical Board of California.
posted by googly at 12:36 PM on June 16, 2011 [19 favorites]

Leave a negative Yelp review, find a new doctor.
posted by I EAT TAPAS at 1:04 PM on June 16, 2011 [3 favorites]

yes, please do file a complaint. you will help those who are too gullible to go elsewhere.
posted by paradroid at 1:06 PM on June 16, 2011 [2 favorites]

Ugh. I dropped an otherwise-excellent dentist once when she started trying to get us to buy into whatever MLM network she was in. As a patient (dental or medical) I already feel vulnerable and that I'm at a something of a disadvantage; having the person who's about to take a power drill to my teeth trying to get me to sign up for Amway creeps me the hell out.

My recommendation would be to drop this doctor and find a new one, and then write the old one a letter explaining your concerns about their apparent conflict of interest and possible violations of the AMA's Code of Ethics (as googly cites above). You might also point out to them that their understanding of the current state of research about obesity and health appears to be out of date.
posted by Lexica at 1:52 PM on June 16, 2011 [1 favorite]

Response by poster: Thanks to everyone for your advice. My wife put a call in to the medical board, who called us back and said they would look into the particular weight-loss plan she's involved with, but kind of left it at that. I think I'll follow up with a written complaint, but maybe also follow Lexica's advice and let her know in more detail why I won't be returning to her practice.
posted by thehandsomecamel at 5:11 PM on June 16, 2011 [1 favorite]

Why not let her know in more detail why you won't be returning to her practice on Yelp so that you can spare others the scammy doctor?
posted by Elminster24 at 9:16 PM on June 16, 2011 [2 favorites]

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