Dispensing with Nicety

I’ ve heard arguments from several well-respected dermatologists that dispensing products in the office is a totally unprofessional practice. And recently, in a dermatology journal, I read an article that basically called physicians who dispense “charlatans” (this from a generation of practitioner that thrived on acne surgery, cryosurgery and PUVA — all of which were paid for by willing insurance companies). No doubt, this is a heated topic that’s generated strong opinions on both sides of the issue, and it’s one that’s not likely to be resolved any time soon. From my perspective, I think that dispensing products can be beneficial to both physicians and patients. One Way of Looking at the Issue The most frequent aspersions about dispensing come from practitioners who say the practice is beneath them. However, it doesn’t make sense to leave patients in the dark about what skincare cleansers and moisturizers would best work for them. In today’s environment, the money is going to be spent on skin care products for everything from acne to wrinkle cures whether the products are purchased online or at home on a T.V. shopping network. Frequently, patients will spend hundreds of dollars on creams sold to them by a high school educated salesperson at a department store counter or at a beauty salon. Often, as long as that person can convince them that their pores are too big or their skin needs exfoliating, the products are appealing. Not providing these people with superior products and knowledge is doing them a disservice. Different Forms of Products Dispensing products may take the form of reselling existing brands or carrying private-label products. Each has its own relative risks and benefits, and I’ll discuss a few of each here. Selling an Existing Brand. This is probably the best way to start dispensing products in the office. First of all, you benefit greatly from having a nationally known company provide you and your office with sales materials and training. The pluses of all of these benefits are impossible to overestimate, especially when you’re just starting out. In addition, the large companies will frequently support your office with product samples, allowing patients to try products without any risk. The public relations and marketing support offered by some of these companies is beyond the reach of most dermatologists. For example, when Skinmedica products appear on “Oprah,” I have patients come to the office and buy all of the products they can carry. The problems with selling an existing brand are that other physicians can also carry the same brand. When the local internist or gynecologist decides that he or she wants to become a spa director, he or she too can purchase the same products. Now, suddenly, you’re all in the same playing field. Another problem with dispensing an existing brand is that you have no control over pricing, and products may be subject to pricing fluctuations. Finally, building brand identity for another company won’t help you retain patients. Carrying Private-Label Products. Private labeling is primarily driven by the fact that dermatologists frequently know enough about the skin to formulate great skincare products. If they can’t directly do this, they can typically identify products that fulfill their specifications. Frequently, these products do not have the national advertising budgets or sales forces required by other skincare products and are available at lower prices. The dermatologist has the opportunity to then supply his or her patients with exceptional products for less than a comparable product at a department store. Ego is also a major component with private labeling of products — as witnessed by the emergence of the “celebrity dermatologist.” Despite what some will say, I would bet that many of our colleagues would not mind being in the position of some of the dermatologists who have broken away from the traditional practice of dermatology. I also think that the emergence of this type of dermatology (good, bad or indifferent) is part of the natural evolution of the profession. This, in and of itself, is worthwhile if only for the introspection and debate it stimulates. To get a sense for whom to work with if you choose to go with a private label, start with the firms that are present at the major meetings and focus on the ones that have been around for a while. I have dealt with many of them and have found most to be very responsive. Displaying Products Properly presenting your products is very important. Once you decide to take the plunge, consult with someone familiar with office interior design so the esthetics are compatible with your office. Displays can come from many places — from specialty stores to online stores to large chain stores. Once they are properly located, have an electrician run lights that will spotlight them. In my office, I have displays in each of the waiting rooms and smaller “mantelpiece” displays in each exam room. Literature about the use and benefits of each product is important and should be prominently displayed with the products. When I first started out, one of my patients, who is a famous businessman and one of the best retailers, told me that my displays “stink.” Looking back, I have to agree. At the time, I wanted to have understated displays, but rather than understated they were so inconspicuous that that didn’t get any attention. Your display is an important factor in how well you will succeed if you do decide to dispense products. Making the Decision Whether you choose to dispense products or not is an individual decision. If you do decide to dispense, private label versus mass product is another decision that needs to be made. Also, you should be aware of the environment you are competing in — know the retailers in your area, what is being sold and at what price. If you make the decision to dispense, I think there’s an opportunity to provide patients with better products at better prices while also helping the health of your practice and insuring that you’ll be around to care for your patients.