IN the coming month we will see for the first time data from the Physician Payments Sunshine Act now entitled the Open Payments Program. Open Payments is a national disclosure program that promotes transparency by publishing the financial relationships between the medical industry and healthcare providers (physicians and hospitals) on a publicly accessible website developed by Centers for Medicare and Medicaid Services.
This public website will be organized and designed to increase access to and knowledge about these relationships and to provide information to enable consumers to make informed decisions.
The goal of the program is to increasetransparency…
The goal of the program is to increase transparency in terms of the relationships that the industry has with health care professionals and institutions. It is important that the public understand the significance of these payments and what to do with the information.
Industry plays a vital role in health care, providing significant support for research, patient care assistance, and education of healthcare professionals. At the same time industry also has a mandate to its shareholders to maximize profitability through sales and marketing.
This can sometimes lead to interactions that may be perceived inappropriate. When a physician prescribes a medication but also has accepted a meal during an educational program, spoke on behalf of the company or received payment for research work on the product, is this automatically inappropriate? The answer should be no, but disclosure of this information is important so that the recipient can make an informed judgment on whether or not to accept the prescription or in some cases the device or procedure.
If a dinner presentation enhances a physician’s knowledge and safe use of a new drug then the interaction is beneficial. If a physician speaks on behalf of the company to increase utilization of lifesaving drugs then the public is well-served. If a physician carries out a high quality clinical trial that enhances our knowledge about the utility of a new drug then the practice of medicine is favorably advanced.
If similar activities are done for ulterior motives then we have a problem.Conflicts of interest in medicine will always exist. Physicians are often given incentives to refer within their own hospital network, use generic drugs, order more tests or order less tests. Physicians often own their own testing facilities and therefore have an inherent conflict of interest when a test is ordered.
Surgeons that recommend an operation gain to benefit financially from the procedure. Academic institutions reward doctors for publications, patents and productivity. None of this is inherently wrong but disclosure is critical to maintaining trust.Open payments should lead to open discussion with your physician.
Your doctor should be able to justify any perceived conflicts and should feel comfortable with your desire to receive an explanation . Trust is essential to a healthy patient-physician relationship. Truth and honesty help build that trust. Let the sunshine in!
