Should You Buy Acne Care Products From Your Dermatologist?
Becoming a doctor in the United States is definitely not an easy task1. It is not just that you have to excel throughout four years in college and four years in medical school and two to eight more years in a residency before you get to practice.
American doctors usually also rack up huge amounts of debt in the form of student loans. Getting out of medical school and owing $100,000 is commonplace. Getting out of medical school and owing $200,000 is not especially unusual2. And those loans can’t be discharged in bankruptcy and doctors can get their bank accounts or property attached if they don’t make their payments—nowadays for decades after graduation. Even worse, loans sometimes have 10% interest rates. And that’s before spending as much as $1 million to set up an office.
And after a total of 22 to 28 years in school, many physicians want some of the finer things in life, too. You can’t blame them for that, but you are the one who pays for them.
Many Dermatologists Get Advice From Marketing Experts
Many dermatologists are being advised by MBAs on ways to make more money by selling acne care products and cosmetics directly from their offices. When your doctor is just starting out in the acne cosmetics business, the sales pitch is likely to be very subtle. The receptionist may stop you for just a moment on the way out and hand you a small gift bag, asking you if you would like to try the products. Then when you come back for your next appointment, the products will be for sale.
After your dermatologist’s office has its cosmetics business up and running, you will probably still get the little gift bag on your way out—but the last person you see will take not only your payment for the visit but also try to sell you a variety of products ranging from sun hats to sunscreen to eye liner and lip gloss.
Just so you know, this whole concept of “office dispensing” gets support from the American Academy of Dermatology, as long as it is in the patient’s best interest3.
Patients Don’t Want To Say No
Most acne care patients are hesitant to damage their relationship with their doctors by saying no and basically being in conflict with the very persons whom they trust4 will treat their skin problems. But the acne care products you buy from your doctor—all of them products you could get at drugstore or cosmetics counter, since most states prohibit doctors from doing double duty as pharmacists in their own practices—are marked up 100% or more and are not likely to be any better than what you can get elsewhere.
What Your Doctor’s Receptionist May Not Tell You
There are things doctors may not want you to know, and we’re not making any friends in the medical community by sharing this information with you. But we think you deserve to know. Here are some important insights into the cosmetics your dermatologist may offer you:
- Private label cosmetics with the doctor’s name on them are usually not really designed by the doctor. Very few physicians have the knowledge of cosmetic chemistry, even if though they are doctors, to design their own formulas. The two disciplines require different skills. With a few important exceptions (the nationally distributed products with a doctor’s name usually actually are designed by doctors), when a doctor sells a cosmetic product with his or her own name on it, it’s just a standard product with the doctor’s private label.
- It costs a lot of money to buy the initial stock of a private label product, usually $10,000 per product. Patients have to buy the products for the doctor to break even.
- Dermatologists come to depend on product sales for cash flow while they wait for insurance reimbursement. It’s not unusual for insurance companies to deny a claim months after the visit and then the doctor has to ask you to pay. But if they can sell you one or two or three $25 to $50 products every time you have an office visit they can cover overhead.
- You’ll probably be told that the products your doctor has for sale are “medical grade” and that they are unique, high-end, or contain exotic ingredients. Be careful if the selling point is “exotic ingredients.” Exotic ingredients have a way of triggering exotic allergies, as well as costing a lot and not doing very much.
- Sometimes doctors will write a prescription for a skin care product on the same pad they use to write a prescription for medication. This is a shameless ploy to make you afraid not to buy the cosmetic, which will be conveniently on sale in the waiting room.
- Doctors may also send you a birthday card in a “lumpy” envelope to get your attention, with a tiny product sample inside. Or you may be informed you are a VIP customer and be offered free makeovers after you buy a certain number of products. Be assured the makeover isn’t free.
- Doctors are told that the word “free” keeps patients coming back. They can always make their procedures more expensive to cover the cost of “free” and sample cosmetics for acne.
A common theme in most of the articles and blog posts on this site is that the best acne products usually don’t cost the most money. Lists of ingredients designed to impress you, by adding exotic-sounding botanical ingredients or antioxidants that require special containers to stay fresh (and that usually are not packaged in those containers), at best just cost you extra money. Sometimes the very ingredients added to justify a premium price also cause you to break out.
Of course, this does get you back to the doctor’s office and paying yet more office visit fees.
Many American doctors really do become quite wealthy, although dermatology is one the lower-paid specialties, just a little over $200,000 a year for dermatologists5 who spend most of their time on medical dermatologist up to about $2,000,000 a year for dermatologists who do cosmetic dermatology in New York or Los Angeles.
That $200,000 a year isn’t a whole lot while doctors are still paying off their loans—but you don’t have to buy your doctor a Rolls Royce. Don’t buy acne care products from your doctor when you can find equal or better quality products at much lower cost in stores. It’s not good for your financial well-being, and ultimately your doctor is better off creating truly original house brands of products that he or she can claim as unique. And if your doctor writes “prescriptions” for cosmetic products he or she also sells in-house6, consider seeing another provider.
- Mowery Y.M. A primer on medical education in the United States through the lens of a current resident physician. Annals of Translational Medicine. 2015;3(18):270.
- Rohlfing J., Navarro R., Maniya O.Z., Hughes B.D., Rogalsky D.K. Medical student debt and major life choices other than specialty. Medical Education Online. 2014;19:25603.
- Farris P.K. Office dispensing: a responsible approach. Seminars in Cutaneous Medicine and Surgery. 2000;19(3):195-200.
- Dorr Goold S., Lipkin M. Jr. The Doctor–Patient Relationship. Journal of General Internal Medicine. 1999;14Suppl1:S26-33.
- Tierney E., Kimball A.B. Median dermatology base incomes in senior academia and practice are comparable, but a significant income gap exists at junior levels. Journal of the American Academy of Dermatology. 2006;55(2):213-9.
- Draelos Z.D. The dermatology dispensing debate. Skin Therapy Letter. 2007;12(9):1-3.
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