Margaret Beeson, ND: In-Office Dispensary Income Support Time with Patients in Integrative Practice
Written by John Weeks
Margaret Beeson, ND: In-Office Dispensary Income Supports Time with Patients in Integrative Practice
Summary: Margaret Beeson, ND, owns and operates a Yellowstone Naturopathic Clinic, a complex which includes a 4 NDs, a spa, associated chiropractic and dental offices and a natural products dispensary. In this contribution to the Integrator dialogue on the potential conflict of interest issues in doctors selling products for a profit, Beeson offers 3 core arguments. The most important is an honest acknowledgment that product incomes helps buy the time she takes with patients and the staff to support their care. Are natural product sales the "procedure" that floats holistic practice? Heck, could they be part of the economic strategy to lure more MDs to primary care?
Beeson: Product sales provide the float that allows time with patients
The controversial practice by many integrative care providers of profiting from the sale of natural products
in their own offices has been a long-time discussion topic in the
Integrator. David Matteson,
a consultant to practitioner organizations who is a part-owner of a
supplement firm kicked off the dialogue in 2007 with a perspective piece. (Matteson, whose principal consulting is with the American Association of Naturopathic Physicians, was recently named treasurer of the Natural Products Foundation.)
Other commentators have included Integrator columnists
Michael Levin and Bill Benda, MD, holistic/integrative leader Patrick
Hannaway, MD, and managed integrative care specialist Adrian Langford. (See article list above.)
Integrative clinician Margaret Beeson, ND, recently weighed in on the topic. Beeson owns and operates the Yellowstone Naturopathic Clinic,
a robust natural healthcare complex that includes a 4-ND clinic, a
spa, a chiropractic office, a dental office and a natural products
dispensary. Beeson, whose first healthcare practice was in nursing, is a
1989 graduate of Bastyr University's naturopathic medical program. She
is a national leader in the effort to expand residency opportunities for
naturopathic physicians. She co-founded the Naturopathic Residency and Research Consortium to advance these opportunities.
______________________________
"Grateful to Maintain a Quality Dispensary in My Medical Practice"
"I think that it is great that there is
serious consideration of the topic of doctors selling supplements in their practices.
"It seems that lately I am noticing that if
an idea or practice, or even a law, does not work a well as many would like,
the tendency is to toss out the idea, etc, as opposed to finding out what may
work and setting parameters that will provide a ‘safe' practice. There may
always be those who find the need to take a larger share of the pie or
seemingly take advantage of others, however it does not make the law, practice
or idea a bad one.
"Many
patients like the convenience
and confidence they experience
when we are able
to provide them
the products that we recommend."
"I
am proud that I am able to offer products in my dispensary that I believe are
the best, most reasonably priced and combine substances that may otherwise have
to be taken separately, in several caps or tabs.
"Many
patients like the convenience and confidence they experience when we are able
to provide them w/the products that we recommend. I let people know where some
of these products may be available elsewhere in town, and request that our
compounding pharmacy and local Coop carry what they can, again for greater
convenience and availability.
"Having a dispensary has allowed me to be able to employ &
support good staff."
"I
am uncomfortable with the generic advice that patients receive in health food
stores, regarding supplements and botanical medicines, as many who supply this
advice are either untrained or minimally educated. I think that, in part,
we get the results that we do because we have access to really great products
and research that allows us to select substances that we have confidence in.
"Lastly,
it is true that having a dispensary has allowed me to be able to employ &
support good staff to serve my patients well, and to run a practice which is
successful for patients and our community. It allows me to spend ample
and necessary time with patients, to get an understanding as to why they may be
sick and to educate in a manner that helps them to be successful in their
journeys to health.
"These are my goals as a doctor, patients first and
business second, well managed to be able to provide good quality care.
For all these reasons I am grateful to be able to maintain a quality dispensary
in my practice."
______________________________
Comment:
One of the issues, throughout medicine, is how to adequately compensate
primary care practitioners. More specifically, how do we pay providers for whom the chief "procedure" is the give-and-take of the time-intensive engagement with patients on education and lifestyle change?
The
homepage of Beeson's Yellowstone Naturopathic Clinic describes this
poorly compensated "procedure" this way: "At YNC, we partner with every patient in compassionate care, health
education, lifestyle management, and health-centered treatment."
While I don't expect HHS Secretary
Kathleen Sibelius will soon be
recommending natural product sales
in all primary care offices ...
I
have heard naturopathic doctors defend their sales of supplements as their way of economically compensating for not having a medical procedure that brings a quick dollar. They haven't the chiropractor's quick adjustment or the acupuncturist's ability to work on 3 or more patients at once.
Beeson makes a good, straightforward, honest case for this practice.
General acceptance of this practice could have interesting (if utterly unlikely) repercussions. Imagine Health and Human ServicesSecretary Kathleen Sibelius promoting natural product sales in all primary care offices as an income incentives to lure more MDs, nurses and PAs into primary care. We could thus begin to measure the potential health outcomes from incentivizing primary care practitioners to prescribe natural products in lieu of conventional pharmacy. Got any bets on what we'd find?
It is, as Hemingway said at the end of The Sun Also Rises, a pretty think to think about.
Meantime, Beeson's line of thinking in her 2nd paragraph is intriguing. What are "the parameters that will provide a ‘safe' practice" so that patients are less likely to be over-prescribed these products?
Send your comments to
for inclusion in a future Integrator.
