As the American Medical Association tries to revamp a controversial product-endorsement deal that drew national criticism, it might want to look closely at the oldest-known commercial seal of acceptance by a healthcare association.
The other behemoth doctors' group, the American Dental Association, hasn't drawn similar rebukes for its 67-year-old endorsement program. But then, it hasn't tried to make money off its endorsements.
The ADA program is financed in large part by its 141,000 member dentists and intended to identify products that meet certain quality criteria.
"It's important that both consumers and dentists have a way to ensure the products they are implementing are effective, and our program does that," ADA spokesman Chris Martin says.
In contrast, the AMA's endorsement deal with Sunbeam Corp. would have compensated the association based on product sales. To critics, it appeared a profitmaking venture designed without regard for patients.
The exclusive, five-year deal would allow Delray Beach, Fla.-based Sunbeam to append the AMA seal to some of its devices, such as heating pads and blood pressure monitors.
The AMA wouldn't actually test the Sunbeam products itself, and during the Sunbeam contract it wouldn't endorse competing products regardless of their clinical effectiveness.
For its good name, the AMA would receive compensation based on sales, although it didn't disclose the exact financial terms of the deal or how much money it hoped to make.
A torrent of criticism followed from other physicians' organizations, watchdog group Public Citizen and media. "The physicians' word descends to that of any other celebrity huckster," the New York Times opined in an Aug. 14 editorial.
Late last month, the AMA apologized for the deal. Top association executives publicly pledged the AMA seal would not appear on Sunbeam products and the association would not accept sales-based fees (Aug. 25, p. 8).
Sunbeam's stance on the matter, however, wasn't known. According to analysts, the AMA name is potentially worth millions of dollars to the corporation.
The ADA says its Seal of Acceptance program can't be compared to the Sunbeam deal.
"We have no exclusive arrangements, and any manufacturer can voluntarily submit products for review," Martin says. "We don't get any royalties."
And ADA certification isn't a rubber-stamp process, he says.
Manufacturers voluntarily submit their products for review. Consultants and ADA staff members then decide whether the products meet association standards for safety and effectiveness.
Among the more common products submitted for review are dental floss, mouthwash, toothpaste and toothbrushes. Some 1,300 products carry the ADA seal, roughly 30% of which are sold to consumers.
More than 300 part-time consultants and about 20 full-time ADA employees carry out the certifications.
About two out of five products fail, Martin says. For example, 30% of toothbrushes submitted didn't meet the ADA's standards in a recent study.
"That doesn't mean they won't eventually get the ADA Seal of Acceptance," Martin says. "We try to correct the problem."
The packaging and advertising that will accompany the products also undergo review.
"We do that to ensure the consumer is getting a product that is supported by the clinical data submitted," Martin says. "Those are our standards that we have developed."
The entire program costs $1.2 million annually, Martin says. Manufacturer fees, first charged in 1995, account for roughly one-third of the program's budget. The remainder comes from association membership fees.
Manufacturers of consumer goods like toothpaste pay $9,000 per product when submitted for review. The price for submitting professional products, such as latex gloves, is $500. Subsequent maintenance fees for both consumer and professional products typically run $150 annually per product.
"The submission fee is charged whether it passes the test or not," Martin says.
He says the ADA program is a public service
"It's important that both consumers and dentists have a way to ensure the products they are using are effective," he says.