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

"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."

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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: