I am a leader. I am a natural born entrepreneur. I’ve always had this innate response to solve problems, look for the root cause and help others; more specifically to help others achieve optimal health.
Back in my younger days while I was raising an infant and attending nursing school, I earned money by selling Mary Kay cosmetics. It was fun helping people try the products and it provided me some income while in school. After I graduated, this cosmetic selling career went to the curb.
During my hospital nursing days, I organized a small group of women and we pitched in to create bulk orders of natural goods, vitamins, and healthy foods. I was the organizer and the leader.
Now, twenty years later, I find myself circling back around to selling cosmetics as well as vitamins. This time, I’m selling not only to make money but to impact lives. Which is something I do daily in my clinic.
For years prior to becoming a functional medicine nurse practitioner, I put my health into the hands of many natural and integrative practitioners. My care always included supplements and I always purchased the nutraceuticals recommended by the practitioner.
When I started my private practice in functional and integrative medicine, I had reservations about selling supplements to my patients. Was it ethical? Would I feel like a salesperson? But I came to find out that my patients wanted to purchase quality supplements from me. They also wanted to know more about the products I used.
In my functional medicine training, the topic of selling supplements was discussed in the context of Stark Law and the ethics behind health care practitioners selling an item. Stark Law, often referred to as the self-referral law, and the broader federal anti-kickback laws exist to prevent (or at least limit, as there are a number of exceptions) healthcare providers from making referrals to patients for services that the provider has a financial interest in. The objective of these laws– to ensure that medical professionals are not making recommendations based on profit rather than quality of care– is good, but there are a number of ethical grey areas here.
I write this blog because this is such a controversial and sensitive topic, and it’s one on which I feel the need to share my practitioner’s point of view. And I will be authentic with my thoughts on this topic.
I supported BIG PHARMA for years! The first very strong thought that comes to mind as I write this is that for more than 6 years, I sold pharmaceuticals. I literally wrote over 20 prescriptions a day, sent patients to the pharmacy, and instructed them to take drugs that were likely contributing to a progressive disease state. I visited with pharmaceutical reps, I accepted their gifts– pens, nice gadgets, elaborate lunches and dinners. How is that not seen as unethical? Well, some clinics and organizations are actually starting to ban it. Research has shown that 94% of doctors in the US receive gifts, including free meals and drug samples, from pharmaceutical companies . And studies have consistently shown that providers are influenced by these reps and their gifts, with gifts as low as $20 in value found to influence prescribing rates! [2, 3]
By the end of my conventional medicine career, I was avoiding pharma reps like the plague.
Now, I take pride in supporting neutracuetical companies that help to treat the root cause of disease as opposed to pharmaceuticals that treat only the symptoms.
It took me a few months in my practice to connect with my true feelings on the subject of selling supplements.
The next important point that comes up is financial sustainability. I have to survive financially! In my functional medicine practice, I spend a significant amount of time with each patient, which I believe is essential for their care. But the fact of it is that because I am not seeing 20+ patients per day, my insurance reimbursement is low. This means that my salary is low. There were months in my early days that my supplement sales helped to pay my bills. Many other functional medicine practitioners would tell you the same thing. Especially those of us who bill insurance.
I am still conservative in my approach, as my goal is not to have patients taking numerous supplements daily. I am passionate about using food as medicine. And my protocols are individualized. I do not believe that every patient who comes through my door needs a probiotic or a fish oil or even a multivitamin! But early on in treatment plans, supplements are often necessary.
As my functional medicine training advanced, I started covering topics like toxicity and environmental medicine. At this point, it was impossible not to start talking with patients about reducing their toxic load from daily living. This meant discussing water filters; beauty products; hair dyes; cleaning products.
I started to notice that most practitioners in my field, including many of the functional medicine leaders I admired, were setting up affiliate accounts with “healthy living” companies that sold things like water filters, air filters, and natural beauty products.
This was another step in letting go of my belief systems. Here I was talking daily with patients about these products, offering my expertise and making my recommendations, and yet nobody was paying me to take the time to talk about it. Insurance companies don’t pay for this type of education.
I had already let go of the belief system that I had to function like a conventional clinic. I was far from the “norm” in my practice.
So I decided to create affiliate accounts, and offer links to the stores I recommended right from my website. This was a surefire way for me to reach hundreds of patients and also value my time.
A bonus for my patients is that I can offer some of these products at a discounted price. Austin Air Purifiers, a clinically proven brand of air filters, are one example. During fire season 2017, I sold more than 10 of these units at my reduced cost!
I love their products, their mission, and the fact that it’s run by women who are passionate about safe, clean beauty products. And this company is active in lobbying for clean beauty products and higher standards for the entire industry.
Again, this is part of my business. Some may say it feels too “sales-y” to have these kinds of affiliate relationships. Some may not want to purchase products from a health care practitioner at all. That’s fine. It’s a personal opinion. My patients are free to purchase from whomever and wherever they feel most comfortable.
I hold high morals and standards and don’t believe there is anything wrong with a practitioner creating their own supplements, selling supplements they believe in, or selling other products intended to improve one’s health. How is that wrong? But writing prescriptions to support the pharmaceutical industry is right? I challenge you to think about this.
At the end of the day, I’m proud to refer patients to a place to shop for reputable, high quality vitamins, herbs, beauty products, and home products to improve their overall health. That’s my goal. And it’s your choice who you support and where you purchase from. Just like it’s your choice if you take a drug, take a vitamin, or use food as medicine.