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As president of a company encouraging dermatologists to office dispense, I feel compelled to respond to Epstein's recent letter in the ARCHIVES.¹ Epstein mentions loss of integrity connected with dispensing. While most dermatologists are not selling products, all are selling services. I would argue that if dermatologists can sell their services with integrity it seems unlikely that they will somehow have a different moral standard for products they sell to patients. I personally would be concerned about seeing a physician who does not dispense for fear of losing integrity. How can a dermatologist who cannot trust himself to behave ethically with dispensing be counted on to act in my best interest with less obvious fee-for-service decisions?

Regarding being "objective about a product you are also selling," I must remind Epstein about the harsh realities of the open market. Unlike many dermatologists' professional services, dispensed products are paid for in cash. . . . [Full Text of this Article]

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