Dr Perle's article on ethics in purchasing for chiropractic treatment.http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=5428

Baird, Rand

Perle, Stephen M.

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Ethical Purchasing And Selling By DCs

Ethical Purchasing and Selling by DCsBy Stephen M. Perle, DC, MS and Rand Baird, DC, MPH, FICA, FICC"Ethical purchasing put simply is buying things that are made ethically by companies that act ethically.Ethical can be a subjective term both for companies and consumers, but in its truest sense means withoutharm to or exploitation of humans, animals or the environment."1We would like to suggest another way of looking at ethical purchasing - from a chiropractic professionalviewpoint. Chiropractic ethical purchasing occurs when chiropractors, chiropractic colleges andorganizations make purchasing decisions based upon both the ethical purchasing model (above) and bypurchasing goods and services only from vendors that support the chiropractic profession. "Vendors thatsupport the chiropractic profession" means that the vendor has a corporate membership or sponsorship inchiropractic associations (international, national and regional/state/provincial/local), makes regulardonations or other financial assistance to chiropractic colleges, participates in chiropractic causes (e.g., theFoundation for Chiropractic Progress) and/or exhibits regularly at chiropractic events.  This includes the simple concept that, other things being equal (quality of the products, level of service, fairprice, prompt delivery, convenience factors, what is best for the patient, ethical purchasing concerns, etc.),the chiropractic purchaser should give preference to the vendors who support the profession, not necessarilythe individual chiropractor. This means there are no kickbacks, improper rebates, or referral fees. Making one’s purchasing decisionsbased upon what the doctor of chiropractic gets from the company make us no better than those in themedical profession who prescribe drugs based upon the free samples, pens, dinners and other perks they getfrom the drug companies. There has been significant discussion in journals, newspapers and on the Webabout problems with drug company inducements.Some years ago I [Dr. Baird] coordinated a group of chiropractors seeking to obtain hospital admittingprivileges. A few months after gaining the sought-after medical staff appointments and concomitant hospitalprivileges, I was called to a confidential conference by the hospital administrator, who had been a strong- 1 -chiropractic advocate. He regretfully informed me that one of the DCs was well-known to use a privateradiology group for his MRIs and CT studies. This violated the administrator’s expectation that DCs on staffwould patronize the hospital’s own radiology department - after all, we were now all members of the samefraternity, and certainly should have been patronizing the only hospital in the area that waschiropractic-friendly and had granted us privileges. When I investigated, I found that both the private facility and the hospital had comparable equipment andwell-qualified radiologists and technicians, but that the marketing manager of the private group was givingthe DCs a $200 "rebate" for each procedure performed! Not only did this renege on the DC’s commitmentto the hospital and violate medical ethics, and was even potentially illegal, but it also was not an ethicalpurchasing behavior by the chiropractor. The hospital had shown its support for the chiropractic profession;we should have done the same and showed support to the hospital.Other things being equal (or close enough to equal for valid comparisons), ethical purchasing bychiropractors means selecting vendors at least in part by investigating and determining if they support theprofession. Not to do this, we believe, is a long-term self-defeating behavior that affects the future of the profession.The World Federation of Chiropractic (WFC), the umbrella organization composed of the nationalchiropractic associations of some 92 countries, has numerous corporate associate members (visit www.wfc.org and click on "Associate Members"), including vendors who sell chiropractic tables andequipment, X-ray machines, nutritional supplements, topical pain gels and creams, supplies, foot orthotics,mattresses, management software, orthopedic supports, technique seminars, media advertising space,management and marketing consulting, etc. - basically anything and everything a chiropractor would needto operate a practice. These companies all support the profession; so why, pray tell, would a chiropractoreven consider purchasing from a company that does not support the profession?For example, when a chiropractor is considering buying an expensive item such as a $40,000 cold laserinstrument and system, would it not be more ethical and make more sense to buy from a company that has areputation for generosity toward the profession? Should the DC buy from the company that is a supporter ofthe WFC, national or state/provincial/local chiropractic organizations, etc., or from some company thatnever gives anything back to the profession? To us, this is a classic "no-brainer." - 2 -And consider this: If more and more chiropractors let it be known that they only buy items, large or small,from companies that support the profession, would this not be a subtle (or not so subtle) inducement thatwould lead to even more vendors supporting our profession? Larger companies should be expected tosupport us more, and smaller companies to a lesser degree, but all should be expected to contribute a fair share.Chiropractors should patronize only those vendors that support our profession year after year. Many include"corporate sponsorships" and "community goodwill" as regular parts of their annual budgets. On the otherhand, surprisingly, some other companies that sell quality products actually have adopted a policy of "nomemberships, no corporate sponsorships!"Now let’s talk about ethical selling for a minute. Some of the items chiropractors purchase from vendors arethen sold to patients. Decisions about what to stock to sell to a patient must be made based upon thepatient’s best interest. Could the patient get the same or comparable product from an outside vendor at abetter price? If so, why carry the product? Patient convenience or doctor’s profit or perks? ]Here are a few examples. I [Dr. Perle] had a patient once who was an insurance consultant. Her insurancecompany would not pay for a particular cervical pillow, as they said it was too expensive. She called me upand said she had seen the same pillow at a local department store for twice what I charged. The insurer paidthe bill. Eventually, there was a vitamin store that sold "professional" label supplements for less than I coulddue to their volume. It was time to get out of the vitamin selling business. The point here is that, all thingsbeing equal, if you cannot provide patients with products at a price they can get the identical products forsomewhere else, you should not try to sell them the products. That is ethical selling behavior personified.We believe that the chiropractic colleges should be teaching ethical purchasing and selling in their businessmanagement, ethics and jurisprudence classes on campus, and suggesting this to students during theirclinical clerkships. We believe every chiropractor should consider the degree to which various companiessupport and give back to the profession when making their purchasing decisions. Reference1.  "Ethics in Business and Its Relevance to Consumer Behavior." Posted on ArticlesBase.com on Aug. 5,2009. - 3 -Click here for previous articles by Stephen M. Perle, DC, MS.Click here for previous articles by Rand Baird, DC, MPH, FICA, FICC.Page printed from: http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=54289&no_paginate=true&p_friendly=true&no_b=true- 4 -

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Ethical Purchasing And Selling By DCs

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