I was seeing a patient who brought me a bag of supplements she bought from another specialist. I looked skeptical and then she pulled out the list of lab results the other doctor ordered on her. I reviewed the results with her and asked why all these tests were ordered in the first place, some of which I had never ordered in my life. She said she told the specialist she was concerned about her thyroid because there was a family history. What was ordered was over a hundred tests, including vitamin panels.
She told me that the specialist sold her special supplements that are way better than what can be purchased in the pharmacy or other stores. It would cost her about $150 per month, and she was worried about all the severe vitamin deficiencies she had. Looking at the bottle of magnesium, I glanced at the lab result: It was only very mildly decreased. This was something that could easily be replaced with a generic multivitamin.
Next, she brought out the vitamin B12. She was really worried about this one because the specialist told her it was severely depleted. I looked at the lab results again and found that it was, in fact, normal. The specialist had drawn a down arrow next to the value to indicate it was decreased but it, in fact, was entirely normal. I told the patient it was normal, nothing else. Before going any further, the patient told me she didn’t want to go back to that specialist because she told her she needed laser hair removal for a pimple she had. She then pulled out some Costco-sized vitamin bottles that she had purchased from Costco at a fraction of the price. Going through all of them, I advised her on the ones I thought might be helpful and those she didn’t need at all.
While I question the ethics of any doctor who sells supplements to patients that are not based on any scientific evidence, I find it appalling to actually lie to patients to trick them into to buying these supplements that they don’t need, just to make a profit. I walked out of the room and turned to my medical students and held up the copy results. “Whatever you become, do not be this doctor,” I advised them. They were as horrified as I was.
While this may be a violation of ethics, it is definitely worse that a doctor would do this. Patients trust that their doctor is giving them sound medical advice. We have a duty to help our patients, not try to wrestle away their hard-earned money. Evidence-based studies are carried out for a reason: so that we know the evidence when prescribing medications or treatments. As doctors, we need to abide by this evidence. If we do not agree with the evidence, then we need to convince someone to carry out a new study to determine the evidence.
We do not get to create our own science or evidence. There are some supplements that are beneficial, and we are now seeing evidence coming out about the benefits. I expect we will see much more in the future. In the meantime, no doctor should be selling their souls to get patients to buy unneeded supplements.
Linda Girgis is a family physician who blogs at Dr. Linda.
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