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There's no such thing as a free lunch

20 December 2013

There's no such thing as a free lunch

Colleagues will be familiar with the old adage, ‘there’s no such thing as a free lunch’. It ties in with the idea that if someone does something for you, you feel in some way beholden to them, even if they insist that they expect absolutely nothing in return. The psychologists tell us this is because we don’t like the idea of owing somebody – we feel that we should pay them back.

Of course the manufacturers and suppliers are well aware the effect that a ‘free lunch’ might have on members of the profession, and certainly don’t hand out incentives without good reason. All well and good in everyday business, but when it comes to the healthcare professions, these practises can sometimes give cause for ethical concern.

You may for example be aware of the controversy that surrounds the medical profession, where the big pharmaceutical companies often go to great lengths to persuade doctors that drug A is better than drug B. You can see why the companies do it – a single doctor will make hundreds of prescriptions each year, which in turn could generate thousands of pounds of revenue for the company in question. But what about the patient? Are these new products really better, or are the doctors being misled?

Thankfully dilemmas of this sort of scale don’t really apply in dentistry, and the decisions we make don’t normally mean the difference between life and death. But nevertheless, we should ensure we are always transparent in everything we do. Are we recommending products because we truly believe in their effectiveness, or because it just happens to be the latest product the company rep has sold us?

At EndoCare we are the largest users of a certain NiTi system. The company we purchase this system from is certainly warm and friendly, but we’re never incentivised to use the product – we use it as we genuinely believe it to be the best product available. Because we believe this to be the case, when any of our specialists give lectures we say, ‘We use product A and we therefore recommend it.’ This doesn’t mean that we don’t recommend product B, but it means that as professionals, hand on heart, this is what we use and we believe to be good.

Cases like this are fairly black and white when it comes to ethics. We use the product, and recommend it to colleagues because we believe that it is an excellent product. But unfortunately these things aren’t always so clear-cut. This is especially true in cases where the products are all very similar with very little to differentiate between them. 

In these cases, to have the product recommended by a key opinion leader can make a massive difference to how the product is received. But at what cost? Are these people recommending products because they genuinely believe them to be the best on the market, or because they are paid to say the things that they do? Though we’d like to think that we can all tell the difference between those recommendations that are genuine and those that are not, these distinctions aren’t always obvious to everyone, and we can soon find ourselves in very difficult ethical ground.

As dental professionals it should be our duty to always ensure that we are open and honest about any sort of incentive we may have received from the trade, however big or small. Though incentives don’t always take the form of ‘free lunches’ they do often include other inducements such as free lectures and free CPD. While there is nothing wrong with free CPD, we should always remember that nothing in life is ever truly ‘free’. We are offered these incentives in the hope that they may sway our opinion. Though we may be dental professionals, we are also consumers, and we should always approach these events with an open mind, understanding that companies aren’t just doing these things for purely altruistic reasons.

If we are to maintain our integrity as a profession, then we should be sure to be absolutely transparent in everything that we do, and the product recommendations that we give. Even if we are absolutely certain that we have not been influenced by a company’s advances, we should not shy away from making clear any dealings we’ve had – no matter how insignificant we believe them to be. This isn’t just to preserve our reputation as professionals, but ultimately to protect patients’ best interests as well.


For further information please call EndoCare on 020 7224 0999

Or visit

Dr Michael Sultan BDS MSc DFO FICD is a Specialist in Endodontics and the Clinical Director of EndoCare. Michael qualified at Bristol University in 1986. He worked as a general dental practitioner for 5 years before commencing specialist studies at Guy’s hospital, London. He completed his MSc in Endodontics in 1993 and worked as an in-house Endodontist in various practices before setting up in Harley St, London in 2000. He was admitted onto the specialist register in Endodontics in 1999 and has lectured extensively to postgraduate dental groups as well as lecturing on Endodontic courses at Eastman CPD, University of London. He has been involved with numerous dental groups and has been chairman of the Alpha Omega dental fraternity. In 2008 he became clinical director of EndoCare, a group of specialist practices.


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