An ethical debate has arisen among Australia’s doctors after the federal government announced plans to investigate the sale of complementary medicines by GPs.
The Australian Medical Association said that doctors’ purchase of vitamins on a wholesale basis to sell to patients was an ethical minefield.
But a former president of the association, Kerryn Phelps, has rejected allegations of conflict of interest, saying that there is little difference between doctors selling complementary medicines and veterinarians selling dog food.
The federal parliamentary secretary for health, Christopher Pyne, last week announced plans for an investigation by the Australian Consumer and Competition Commission into the growing business practice.
One Queensland GP, Scott Masters, told The Australian newspaper (http://theaustralian.news.com.au, 21 Sep, “Probe on vitamins from GPs”) that a colleague in nutritional medicine was buying $A10 000 (£4000; €5900; $7500) worth of vitamin E supplements at the start of each year and then selling them to patients at 10 times the purchase price.
“That’s not a bad mark-up. This is entirely legal, although there are major ethical concerns about conflict of interest,” said Dr Masters in the article. He added that his practice was being sent increasing amounts of material by the promoters of the supplements.
The commission is already reviewing the code of conduct for the pharmaceutical industry after claims were made that companies were offering inducements to doctors to prescribe certain drugs. The new inquiry means that a similar code could be developed for the prescribing and sale of complementary medicines, after complaints that no legal guidelines in the area exist.
The national president of the Australian Medical Association, Mukesh Haikerwal, said that doctors who sold vitamins to patients had a conflict of interest. And the chairwoman of the association’s ethics committee, Rosanna Capolingua, called the area an “ethical minefield.” She said GPs must declare any pecuniary interests in the sale of products and not mislead their patients.
But Dr Phelps, a doctor who appears regularly on television as an adviser on medical topics and who has a health food business attached to her Sydney practice, said that critics wanted to hold doctors to a different standard from other professions.
“What’s the difference with vets who sell pet food?” Dr Phelps told The Australian . “What’s the difference with physiotherapists who sell exercise equipment?”
She said that although safeguards were needed, the potential advantages of allowing doctors to dispense complementary medicines outweighed any risks.
But the Australian Divisions of General Practice, which represents GPs, said clear guidelines needed to be established, because marketing by doctors could potentially exploit the doctor-patient relationship.
“From a best practice point of view you have to be very clear that doctors’ habits are removed from any pecuniary interest they might have,” said the group’s chairman, Tony Hobbs.