Should my doctor be selling me vitamins?

Q: My doctor recommended I take special vitamins. He sells these at the office. Is this ethical?

A: This is a gray area. In my opinion, a very gray area.

In this instance, it is certainly a practice I find questionable. That said, I hesitate to give you a blanket statement or to condemn sales of all products in doctors’ offices. Instead, I refer you to the position of the American Medical Association, with which I agree.

First, the AMA states that physicians should not sell non-health-related goods from their offices. There are a few exceptions, however: Physicians may sell non-health-related goods for the benefit of community organizations, provided that:

• the goods are low-cost
• the physician does not profit from these sales
• such sales are not a regular part of the physician’s business
• the sales are conducted in a dignified manner
• patients aren’t pressured into buying.

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So, selling Girl Scout cookies to help out the staff’s daughters would be OK, but selling time shares would not.

Vitamins are considered health-related. And when it comes to health-related products, the AMA feels financial conflicts of interest should be minimized. Here, too, they have guidelines:

• Physicians should limit sales to products that serve patients’ immediate and pressing needs. (I am not convinced this applies to vitamins. You may benefit from them, but it’s unlikely the need is pressing.)
• They may distribute health-related products free of charge or at cost to make them easily available. (Are these vitamins being passed to you at cost? Would it be hard to find an equivalent at a store or online?)
• They must fully disclose the nature of the financial arrangement with a manufacturer. (If your doctor is getting a cut of the profits, you should be informed.)

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When it comes to vitamins, I suggest that my patients eat right, with plenty of fruits and vegetables. A multivitamin and calcium supplement made by a reputable company also is a good idea, but getting it from a doctor’s office doesn’t mean that it is superior.

Clearly, if there is an emergency need for a health-related product — for example, you break your leg and your doctor sells you crutches (and doesn’t charge an arm and a leg — excuse the pun!), that is certainly appropriate.

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So are the arrangements that some doctors have with compounding pharmacies or skin-care manufacturers. But, again, the physician should sell these products at reasonable cost. (It could be argued that buying them at the doctor’s office will cost the doctor something for handling and administration, and also save you the inconvenience of a shopping trip.)

The doctor should not insist you buy the product from the office, particularly if the doctor has a deal with the manufacturer to profit from the sale.

Doctors often give patients free samples of drugs supplied by pharmaceutical companies. This is fine. But a doctor should absolutely not sell these samples to patients.

Dr. Reichman’s Bottom Line: Ask questions before buying a health-related product offered by your doctor. Find out what makes it special, whether you can purchase it through regular channels, and whether the doctor stands to profit unfairly from the sale.

Dr. Judith Reichman, the “Today” show's medical contributor on women's health, has practiced obstetrics and gynecology for more than 20 years. You will find many answers to your questions in her latest book, "Slow Your Clock Down: The Complete Guide to a Healthy, Younger You," which is now available in paperback. It is published by William Morrow, a division of HarperCollins.

PLEASE NOTE: The information in this column should not be construed as providing specific medical advice, but rather to offer readers information to better understand their lives and health. It is not intended to provide an alternative to professional treatment or to replace the services of a physician.

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