Expert Offers Tips on Maintaining Ethical Norms

PHOENIX — Cosmetic dermatologists need to remain ethical in how they choose and promote a product or procedure, as well as how they market their practice to patients, according to Dr. Susan H. Weinkle.

Disclose all industry financial relationships to avoid bias, or even the perception of bias. “If you would be embarrassed in any way to discuss your relationship with a pharmaceutical company with your patients or colleagues, it may be time to reassess,” Dr. Weinkle said at the joint annual meeting of the American Society for Dermatologic Surgery and the American Society of Cosmetic Dermatology and Aesthetic Surgery.

Ethical patient counseling is also important. “If you use off-label products in your office, you have to make sure the patient understands what it means,” Dr. Weinkle said. Prior to approval of a cosmetic indication for poly-L-lactic acid injection (Sculptura Aesthetic, Sanofi-Aventis) in July 2009. "I had to explain to all patients it was approved for HIV atrophy, and I was choosing to use for an off-label indication."

Dermatologists are under scrutiny from the government and consumer advocates. “We are obliged to maintain a high standard of safety and maintain the public trust,” Dr. Weinkle said. “When I recommend something, I have to know I am recommending it for the right reason. Would I use it to treat myself and my mother?” Choose a particular laser, for example, because it is the best treatment for a particular patient, not because a payment needs to be made on the device.

Participation on industry advisory panels is appropriate for faculty, she said. It also is ethical to accept reasonable reimbursement for travel, lodging, and meal expenses from industry. Progress in medicine is made in part because of alliances between physicians and industry. At the same time, it is imperative to avoid professional bias or even the appearance of such bias. “If we are working for a company or doing a project—we are human beings—we have to acknowledge there could be professional bias,” she said.

Full disclosure of all relevant conflicts of interest includes interactions with the media, such as granting an interview to a magazine or television station. Also, if you do medical writing, beware of too much delegation. “If you write an article for one of our journals, make sure you are involved and review it,” she said. Disclose any role of other people involved.

Remain ethical when marketing or promoting cosmetic dermatology services. “There are more advertisements near my practice for dermatologists than attorneys,” said Dr. Weinkle, a private practice dermatologist in Bradenton, Fla. She said she had no relevant disclosures related to this presentation.

A final tip from Dr. Weinkle: Review the American Medical Association's Code of Medical Ethics, which is available at www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics.shtml.

Visit www.youtube.com/SkinAndAllergyNews for a video interview with Dr. Weinkle explaining more about ethics and bias.

PHOENIX — Cosmetic dermatologists need to remain ethical in how they choose and promote a product or procedure, as well as how they market their practice to patients, according to Dr. Susan H. Weinkle.

Disclose all industry financial relationships to avoid bias, or even the perception of bias. “If you would be embarrassed in any way to discuss your relationship with a pharmaceutical company with your patients or colleagues, it may be time to reassess,” Dr. Weinkle said at the joint annual meeting of the American Society for Dermatologic Surgery and the American Society of Cosmetic Dermatology and Aesthetic Surgery.

Ethical patient counseling is also important. “If you use off-label products in your office, you have to make sure the patient understands what it means,” Dr. Weinkle said. Prior to approval of a cosmetic indication for poly-L-lactic acid injection (Sculptura Aesthetic, Sanofi-Aventis) in July 2009. "I had to explain to all patients it was approved for HIV atrophy, and I was choosing to use for an off-label indication."

Dermatologists are under scrutiny from the government and consumer advocates. “We are obliged to maintain a high standard of safety and maintain the public trust,” Dr. Weinkle said. “When I recommend something, I have to know I am recommending it for the right reason. Would I use it to treat myself and my mother?” Choose a particular laser, for example, because it is the best treatment for a particular patient, not because a payment needs to be made on the device.

Participation on industry advisory panels is appropriate for faculty, she said. It also is ethical to accept reasonable reimbursement for travel, lodging, and meal expenses from industry. Progress in medicine is made in part because of alliances between physicians and industry. At the same time, it is imperative to avoid professional bias or even the appearance of such bias. “If we are working for a company or doing a project—we are human beings—we have to acknowledge there could be professional bias,” she said.

Full disclosure of all relevant conflicts of interest includes interactions with the media, such as granting an interview to a magazine or television station. Also, if you do medical writing, beware of too much delegation. “If you write an article for one of our journals, make sure you are involved and review it,” she said. Disclose any role of other people involved.

Remain ethical when marketing or promoting cosmetic dermatology services. “There are more advertisements near my practice for dermatologists than attorneys,” said Dr. Weinkle, a private practice dermatologist in Bradenton, Fla. She said she had no relevant disclosures related to this presentation.

A final tip from Dr. Weinkle: Review the American Medical Association's Code of Medical Ethics, which is available at www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics.shtml.

Visit www.youtube.com/SkinAndAllergyNews for a video interview with Dr. Weinkle explaining more about ethics and bias.

PHOENIX — Cosmetic dermatologists need to remain ethical in how they choose and promote a product or procedure, as well as how they market their practice to patients, according to Dr. Susan H. Weinkle.

Disclose all industry financial relationships to avoid bias, or even the perception of bias. “If you would be embarrassed in any way to discuss your relationship with a pharmaceutical company with your patients or colleagues, it may be time to reassess,” Dr. Weinkle said at the joint annual meeting of the American Society for Dermatologic Surgery and the American Society of Cosmetic Dermatology and Aesthetic Surgery.

Ethical patient counseling is also important. “If you use off-label products in your office, you have to make sure the patient understands what it means,” Dr. Weinkle said. Prior to approval of a cosmetic indication for poly-L-lactic acid injection (Sculptura Aesthetic, Sanofi-Aventis) in July 2009. "I had to explain to all patients it was approved for HIV atrophy, and I was choosing to use for an off-label indication."

Dermatologists are under scrutiny from the government and consumer advocates. “We are obliged to maintain a high standard of safety and maintain the public trust,” Dr. Weinkle said. “When I recommend something, I have to know I am recommending it for the right reason. Would I use it to treat myself and my mother?” Choose a particular laser, for example, because it is the best treatment for a particular patient, not because a payment needs to be made on the device.

Participation on industry advisory panels is appropriate for faculty, she said. It also is ethical to accept reasonable reimbursement for travel, lodging, and meal expenses from industry. Progress in medicine is made in part because of alliances between physicians and industry. At the same time, it is imperative to avoid professional bias or even the appearance of such bias. “If we are working for a company or doing a project—we are human beings—we have to acknowledge there could be professional bias,” she said.

Full disclosure of all relevant conflicts of interest includes interactions with the media, such as granting an interview to a magazine or television station. Also, if you do medical writing, beware of too much delegation. “If you write an article for one of our journals, make sure you are involved and review it,” she said. Disclose any role of other people involved.

Remain ethical when marketing or promoting cosmetic dermatology services. “There are more advertisements near my practice for dermatologists than attorneys,” said Dr. Weinkle, a private practice dermatologist in Bradenton, Fla. She said she had no relevant disclosures related to this presentation.

A final tip from Dr. Weinkle: Review the American Medical Association's Code of Medical Ethics, which is available at www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics.shtml.

Visit www.youtube.com/SkinAndAllergyNews for a video interview with Dr. Weinkle explaining more about ethics and bias.