I’d like to solicit your opinion.
As you know, (or… maybe you don’t) MiddlesexMD has an online store in which we sell all kinds of products geared toward the sexual needs and pleasures of older women—“for midlife women who want to enjoy sexuality for life,” as we say. And some products just for fun.
As I’ve explained before, I created this store for a generation of women who need more sexual stimulation, lubrication, and support, but who probably aren’t going to check out their local sex shop (assuming there is one) and who probably aren’t savvy or experienced shoppers when it comes to choosing items like vibrators or warming oils.
So my team and I did the shopping (when was the last time you went to an “adult” trade show?), testing, and selecting of products we thought would be helpful and safe for midlife women.
It wasn’t easy, let me tell you, but I’m proud of our selection, and I’m confident about the quality of their design and construction and the safety of their materials. Full disclosure: MiddlesexMD is a business, so there is some profit involved.
So what’s the problem?
Because I have this dual role—as a practicing physician and as MiddlesexMD, other health care providers ask my advice about product sales. I know that the doctor-patient relationship is a tender thing, and it’s based on trust. My patients trust me to use my skills on their behalf. They don’t want my commitment to their health and well-being diluted or divided by self-interest. Nor do I.
When doctors sell products, conflict of interest is always lurking. Can doctors be objective when they stand to make money by recommending this vitamin or that weight-loss aid? And wouldn’t patients feel some pressure to buy the product to please the doctor? Does the presence of the product in a doctor’s office imply that the doctor endorses it?
The fact that some doctors derive a significant portion of their income from selling these products in their offices reinforces that appearance of ethical shadow-boxing. A few “celebrity” doctors have become virtual mouthpieces for certain product lines, which often lack research as to their efficacy or even safety.
As you can imagine, the issue has engendered passionate discussion both pro and con within medical circles, and professional medical organization have yet to issue any guidance regarding the practice.
I can honestly say that my primary motivation for selling products that I’ve tested and sometimes use myself is to provide a tasteful, private, safe opportunity for women to buy intimate items that will help keep them sexually active and comfortable and that they’d have a hard time finding otherwise. I set prices comparable to other retail options.
I practiced medicine for years before bringing products into my office. My relationships with patients were well-established. And I’ve seen first-hand that women are more likely to follow through when I can show them what lubricants feel like or how a vibrator functions. When my patients can walk out with products they’re ready to use, rather than with one more research project for their to-do lists—well, I think that’s useful and convenient. I’m not sure I would still have an electric toothbrush if my dentist didn’t offer them for sale.
So I’d like to think I’m offering a valuable service to my patients, but can I truly be objective when I have something, however modest, to gain? Do my patients feel subtly obligated? Do I compromise my professional credibility?
What do you think? Service or self-serving? I’d really like to know.
Dr. Barb DePree, M.D., has been a gynecologist and women’s health provider for almost 30 years and a menopause care specialist for the past ten.
8 comments
I once read, “There are five professionals in your life you need to be able to trust – your doctor, your lawyer, your clergy, your accountant, and your auto mechanic”. Anyone who comes back to a professional after the first “I’ll give him a shot” visit does so because she trusts that person – if she didn’t, she wouldn’t be there. One of the things she trusts is your judgement. Be vigilant and do not abuse that trust and there should be no problem.
Anyone visiting this site has an interest in health and physical intimacy issues, and wants to read what you have to say on these topics. If you, in your professional opinion and personal experience, honestly believe a lotion, device, or book to be beneficial, there is nothing wrong with saying so (and one can make the case that you are shirking your duties to your readers and patients if you do NOT mention these things). As for the turning of a profit on the sale, no reasonable person asks you to provide these items at cost – making a reasonable profit from providing a beneficial device or service to a patient is fine. As with much in life, you’ll do pretty well simply by following the Golden Rule – if the roles were reversed, would YOU feel betrayed or abused if your patient treated you the way you’re treating her.
I think you nailed it in your paragraph describing your reasons for providing these products…we TRUST YOU…I trust you completely, but I’ve had a years long professional relationship with you as a healthcare provider. You have a history of taking a personal interest in MY health…I can still remember the first time YOU called me to explain the results of a test…that was the first time I had a Dr. call ME…so maybe you have colleagues who have not worked as hard as you have to develop relationships with your patients…and offering products in their offices would seem a little predatory…but I am personally grateful for the store and have passed it on to my friends…because WHERE ELSE are we going to go for these things? Additionally, it never occurred to me that you are making a ton of cash from these sales, it seems like another way you are keeping your patients health and well-being in the forefront of your practice. You have created a safe place for us to reconnect with an important part of ourselves.
Service. Absolutely. I am mulling over a purchase now and definitely would not shop in an adult store. Please keep your shop.
PS. Wish your practice was in my area as well :)
I am thrilled to have a blog like this that addresses the many issues that I am experencing after menopause. My mother is gone and I have NO one else to talk to about these things. I have written you many times and you have responded promptly and with comforting medical knowledge. I have also ordered your products and feel that you market them in a way that is very helpful. I have never felt that your service was anything other than helpful! Keep up the GREAT work!
I agree wholeheartedly with all of the earlier comments. I just identified your site earlier this week as I searched the internet for resources on post-menopausal conditions and feel your site offers very comprehensive information, as well as solutions, to various sexual health issues in a format that is user-friendly and comfortable. I did not want to make an appointment with my woman’s health provider just to answer some basic questions I had, so I was pleasantly surprised to come across your site.
In regard to your question about “service or self-serving”, one of your roles as a physician is to offer patient advice while abiding by your oath to “do no harm”. Consequently, I do not feel there is anything wrong with recommending specific products when they are based on what you believe from your research or professional knowledge, rather than the profits you will generate. Every professional deserves to be compensated for their time and effort, as long as their charges are fair and reasonable. I personally feel that your prices are fair and reasonable. In addition, It is up to the patient to weigh the options you offer and do what feels right to them. I cannot imagine why any woman would feel obligated to purchase a product from this site.
Finally, I think having sites like yours that are packed with information which can be viewed at leisure and in private, are invaluable. THANK YOU for saving me an uncomfortable visit to an adult sex shop or an equally uncomfortable time standing in the feminine hygiene section of my local pharmacy!