This distinction is very significant for two reasons. This distinction is almost always irrelevant under state law. In addition, these state laws are usually not restricted to just 11 categories of health care products and services. In both scenarios, the doctors are receiving money for sending customers to e-commerce vendors. Violations of Section 650 are criminal.
Doctors are also subject to having their licenses suspended or revoked.
Rather, the doctor is referring the doctor's patients to a vendor or internet company through the doctor's website, and then receiving a commission. If a doctor simply changed the structure of the doctor's e-commerce deal to match how vitamins and orthotics are probably sold at the doctor's office, the legal effect would be very different. In a doctor's office, the doctor usually purchases the vitamins directly from a vitamin company and then provides them to the patient. In the case of a particularly expensive or unusual orthotic, the doctor may wait until after a patient orders such a orthotic before purchasing it. In that case, the doctor collects the money from the patient.