Products must be essential to patient care

December 06, 1999

PHILADELPHIA -- (December 7, 1999) The American College of Physicians-American Society of Internal Medicine (ACP-ASIM) today issued ethical guidelines for physicians who sell products from their offices. The position paper, "Selling Products Out of the Office," is published in the December 7 issue of Annals of Internal Medicine.

ACP-ASIM says that physicians must maintain high ethical standards and should only sell products from their offices under specific guidelines. Products should be essential to the patient's care, clinically relevant to the patient's condition, proven effective in treating the condition, and not easily available to the patient because of geographic or time constraints. Further, physicians should disclose financial interests in products, encourage patients to explore other available alternatives, and limit charges to the reasonable costs incurred in making the products available.

"Selling products from the office is a difficult issue that can affect the patient-physician relationship," says Whitney W. Addington, MD, president of ACP-ASIM. "Selling a product directly from the office is a great help to patients, if, for example, they live in a rural area or if they need a medical device in order to begin treatment immediately."

Lois Snyder, JD, director of ACP-ASIM's Center for Ethics and Professionalism and co-author of the paper, says that "physicians occupy a powerful position with their patients and must take care not to act, or even appear to be acting, in their own financial self-interest."

Under the ACP-ASIM guidelines, physicians should not sell vitamin supplements or cosmetic products, both of which are widely available elsewhere. On the other hand, physicians might sell peak flow meters for asthma, to make sure that patients know how to use them correctly.

The position paper was developed by the ACP-ASIM Ethics and Human Rights Committee, was reviewed by the ACP-ASIM Board of Governors, and was approved by the ACP-ASIM Board of Regents on July 18, 1999. ACP-ASIM also publishes an Ethics Manual, now in its fourth edition. The paper will be available on the ACP-ASIM Web site ( ) on December 7, 1999.
ACP-ASIM is the nation's largest medical specialty organization and second largest medical association. ACP, founded in 1915, and ASIM, founded in 1956, merged in July 1998. Membership comprises 115,000 internal medicine physicians and medical students.

NOTE to Editor: For copies of the position paper, "Selling Products Out of the Office," please call 215-351-2656. The paper will be available on the ACP-ASIM Web site ( ) on December 7, 1999.

American College of Physicians

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