Conflict of Interest? Dermatologists' Ethics in Selling Skincare Products to Patients

Readers,

As patients, we trust doctors to prioritize our well-being over profit. But what happens when your dermatologist starts acting more like a salesperson than a healthcare provider?"

My mother recently bought some top of the line skincare from her longterm dermatologist. During this visit, they explored options, solutions to specific problems and more. As my mother continued this conversation, I kept thinking back to my own visit to another dermatologist. This doctor advised me to get procedures that cost a big buck, instructed me to only use products formulated by their business, and used medical jargon during this conversation that I did not quite understand. All this while, I wondered how much I trusted this doctor who went to medical school had been successfully treating patients for several years. That’s when I realized- there was a quiet shift in the way the doctor approached solutions. Here, he had become a businessman.

In this scenario, it is important to understand what exactly was unsettling. Did I think their products were bad? No. Did I think these doctors were bad doctors? Also no. Really, it was the way that doctors flipped their roles and became advertisers in their own offices that I despised. The problem wasn’t the integrity of the actual product or the person. It was the integrity of the process.

Medical professionals who develop and sell their name brand products must seriously consider how they promoting their business. Their expertise lends them credibility as leaders in skin research and care, but their marketing strategies blur the lines between genuine advice and profit. This creates a conflict of interest.

Living in a commercialized world with overconsumption galore, ads follow us everywhere — from social media to our daily stroll, we are constantly manipulated by marketing. We recognize that as a mainstay of business. But when this begins to seep into spaces we previously thought were safe and meant for caregiving, it can be concerning. Should I believe my doctor genuinely thinks this product will help me, or are they trying to push overpriced skincare the same way influencers do?

This leads to a broader question: where do we draw the line between medical advice and business? Patients turn to doctors for their expertise and unbiased guidance, not to feel like customers in a store. The moment a doctor’s recommendation becomes entangled with profit, it can make us question their true motivations.

Dermatologists still hold significant influence in determining purchase decisions for their patients. According to yearly American Society of Dermatological Surgery surveys, medical practioners in skincare have the highest amount of influence on product purchase. In a 2021 online independent survey, 32% respondents said that the most influential factor in them determining which skincare products to buy were dermatologist advised. This is only meagerly more than the 31% who credited social media but social media is well-known for its influence on the beauty market. Even so, doctors still hold significant influence in this space. Additionally, they hold more credibility and knowledge than social media beauty gurus which is why their advice is labeled more trustworthy.

So when a doctor blurs the lines between professional care and personal business, it can erode patient trust. If patients begin to see their doctor as a salesperson, they may second-guess medical advice, which can compromise not only their care but also the broader patient-doctor relationship.

Up until 1975, the American Medical Association prohibited medical professionals from advertising ANY medicines. This applied to pharmaceuticals as well as direct to consumer products (like skin creams). The U.S Supreme Court case, Goldfarb v. Virginia State Bar, changed the course of medical marketing for all kinds of products. The bases of the previous prohibition was that medical marketing would lead to declining trust in patients and the public. Now that medical marketing is permissible, this erosion of trust can be observed.

Trust in health services has indeed been steadily declining for decades. While insurance and pharmaceutical companies and administrative services bear the brunt of this distrust, and rightfully so— public trust in doctors, physicians, and nurses has also declined. In such a case, if doctors or health care specialists begin to sell you on things, it can develop deeper mistrust, and a sense of exploitation.

Dermatologists are perhaps the most qualified persons to steward skincare. They are doctors first and have dedicated years of their life simply understanding, learning and researching our skin and bodies. I do not have a problem with them using their knowledge and improving and introducing quality care in the market that is backed by research and science. What I do have a problem with is their mismanagement of roles. I expect transparency when I see these dual roles operating. It is understandable to use your clients to push your business, and when done well- can help a lot of people. But I want to know that for the professional, my wellbeing comes first as I sit in the office looking for advice.

It is unto the practitioner to bear the responsibility of developing trust in their patients. There is a knowledge gap which indeed puts that burden on the practitioner. Looking at new patients as potential customers is not really the best way to do so. As they practice their right to develop and distribute products, they also need to take responsibility to communicate and foster a culture of care in their professional offices.

Now comes the tough question: So what exactly is the solution? While there will always be a dichotomy of the doctor/salesman persona, it is possible to balance those. I am no medical ethicist, however, and my job is really to question things. I do believe that total transparency must be practiced at all times, but as for the nuances of medical marketing— it can be a complex issue that requires deep thought, research, and understanding. I hope that with advances in skin science and medical marketing, these questions are raised more, and that there is dedicated study to understanding these nuances.

Yours Truly,

Tinderella