I was seeing a patient who brought me a bag of supplements she bought from another specialist. I looked skeptical and then she pulled out the list of lab results the other doctor ordered on her. I reviewed the results with her and asked why all these tests were ordered in the first place, some of which I had never ordered in my life. She said she told the specialist she was concerned about her thyroid because there was a family history. What was ordered was over a hundred tests, including vitamin panels.
She told me that the specialist sold her special supplements that are way better than what can be purchased in the pharmacy or other stores. It would cost her about $150 per month and she was worried about all the severe vitamin deficiencies she had. Looking at the bottle of magnesium, I glanced at the lab result: it was only very mildly decreased. This was something that could easily be replaced with a generic multi-vitamin. Next, she brought out the vitamin B12. She was really worried about this one because the specialist told her it was severely depleted. I looked at the lab results again and found that it was in fact normal. The specialist had drawn a down arrow next to the value to indicate it was decreased but it in fact was entirely normal. I told the patient it was normal, nothing else. Before going any further, the patient told me she didn’t want to go back to that specialist because she told her she needed laser hair removal for a pimple she had. She then pulled out some Costco-sized vitamin bottles that she had purchased from Costco at a fraction of the price. Going through all of them, I advised her on the ones I thought might be helpful and those she didn’t need at all.
While I question the ethics of any doctor who sells supplements to patients that are not based on any scientific evidence, I find it appalling to actually LIE to patients to trick them into to buying these supplements that they don’t need, just to make a profit. I walked out of the room and turned to my medical students and held up the copy results. “Whatever you become, do not be this doctor”, I advised them. They were as horrified
While this may be a violation of ethics, it is definitely worse that a doctor would do this. Patients trust that their doctor is giving them sound medical advice. We have a duty to help our patients, not try to wrestle away their hard-earned money. Evidence-based studies are carried out for a reason: so that we know the evidence when prescribing medications or treatments. As doctors, we need to abide by this evidence. If we do not agree with the evidence, then we need to convince someone to carry out a new study to determine the evidence. We do not get to create our own science or evidence. There are some supplements that are beneficial and we are now seeing evidence coming out about the benefits. I expect we will see much more in the future. In the meantime, no doctor should be selling their souls to get patients to buy unneeded supplements
Copyright secured by Digiprove © 2016 Linda Girgis, MD, FAAFP
Dear Dr. Linda,
I’ve read your article on questioning the ethics of any MD who sells supplements to patients, excellent.
What are your thoughts on now doctors and PA’s promoting these designer fad pain creams? They send your personal and insurance info. to a compounding pharmacy to mail you a customized topical pain cream in which you’re clueless as to what’s in it and find out through special mail delivery that there is ketamine in it and you have no idea how much to use and where to put it. Let’s try the whole tube!
Wow what hallucinations! Never mind if you happen to have adverse health effects, which of course due to how these ingredients come, combined in this way isn’t approved by the FDA because there’s no way to quantively measure the safety of the totality, whereas compared to the individual components themselves.
This was my situation, fortunately I cancelled the automatic delivery after getting further info. I’m finding out that some parties are financially benefiting with incentives upon patients obtaining these creams from the mail delivery pharmacies, in which they have a co-existing agreement, and in some cases an actual script is bypassed from the doctor.
I find this is also becoming a way for doctors and PA’s to prescribe less opiates, but in reality is setting someone up for a further dangerous scenario without access to medical supervision in which case there may be unconsciousness.
I recently had a sales rep. (prior to PA endorsement,) for these creams from this pharmacy cold call me asking if my dog, my mom or myself was in pain and for 2K would send me a pain cream that would take my pain away.
They are connected with my pm clinic who’s having a PA do this with patients in which they don’t have a clue as to what they’re getting.
I question ethics across the board especially with what’s happening to chronic pain sufferers who are being allowed to suffer with legitimate pain who’ve never abused their medications. It’s happening to me. I have severe spinal degeneration and dysautonomia.
Outraged patient
I pretty much support evidence based medicine. Until it is supported by science, we should not be promoting it, and definitely not profiting from it. Hope you feel better and find some relief.