Open Payments: Will Disclosure Hurt Or Help Patients?

This week, Dr. Leana Wen, founder of Who’s My Doctor, was interviewed on CBS This Morning about whether the government’s Open Payments website should be delayed. This is part of the Physician Payment Sunshine Act that will provide public access to payments made to physicians by pharmaceutical and medical device companies. In her words:

Over the years, I have become
increasingly concerned about the harmful effects of financial conflicts of interest on patient care. Dozens of studies have shown that financial relationships between doctors and drug/medical device companies influence physician prescription practices.

My research on patient-centered care also shows that patients are concerned about these potential conflicts of interest and how they may affect their care. Our patients deserve to know how their doctors are paid and whether this may affect them. The Sunshine Act will provide much-needed, critical tools for increasing transparency and accountability, and will help exert pressure to prevent inappropriate financial relationships between doctors and industry in the future.

The Open Payments website that will display the payments to doctors has already been delayed by more than a year. Now, in light of some technical problems, physician groups including the American Medical Association are arguing that there should be another six-month waiting period. While it is important to provide doctors an opportunity to review and dispute payments to them, this should not delay timely release of physician payments data to the public.

The American Medical Association argues that inaccurate information could undermine trust. If physicians want to improve trust, they can take a proactive approach and begin conversations with patients. They can send out an email or letter clarifying their affiliations with drug companies. They can participate in Who’s My Doctor and explain their philosophy publicly, online. They can have one-on-one conversations with those who have questions. Such openness will only improve the doctor-patient relationship, improve trust, and increase accountability.

For those doctors who truly are ashamed of their payment history, perhaps they can reevaluate their financial relationships. As former Supreme Court Justice William O. Douglas said, “Sunlight is the best disinfectant.” The sunlight is available now. Physicians and patients alike should
embrace it, now.

Parts of this post were part of an open letter Dr. Wen sent to Ms. Marilyn Tavenner, CMS administrator, on May 27
th 2014 with the subject of “Revision of a currently approved collection; Title of Information Collection: Registration, Attestation, Dispute & Resolution, Assumptions Document and Data Retention Requirements for Open Payments (CMS-10495).”

Letter to the Editor: A Light On Drugs

Dr. May Nguyen, a founding member of Who’s My Doctor, wrote a letter to the editor in the Houston Chronicle and the need for transparency:

“I was disappointed that only one sentence in the entire article alluded to the research about the influence of pharmaceutical representatives through their free pens, dinners and drug samples….
Studies led by Dr. Richard F. Adair published in 2005 and Dr. Barbalee Symm published in 2006 have demonstrated that drug samples do influence physicians to prescribe the sampled drugs more frequently.
A recent study led by Michael P. Hurley and his colleagues from the Stanford University School of Medicine and published this year revealed that free drug samples guided dermatologists away from prescribing less expensive generic medicines…..
Patients must be able to trust that their doctor is prescribing medicine that is evidence-based, not because he or she received a free sample.”

AP News: Who Pays Your Doc?

Matthew Perrone’s piece in AP News mentions Who’s My Doctor, and quotes Dr. Leana Wen and Dr. Stephen Smith, members of the WMD.

AP News. Who Pays Your Doctor? Coming to a Site Near You. July 9th, 2014.

"My Total Transparency Manifesto"

I am participating in the Who’s My Doctor campaign because it is important that patients know that I accept no money from drug companies or device companies. I am not making money from ordering more tests or pushing you as a patient to make certain medical decisions. I understand that I am a stranger with whom your share the most personal information and I consider this a privilege. Read More...

British Medical Journal's Editor's Choice!

“…Declarations of interest are now standard practice for publication in medical journals. The same should be true for our dealings with patients.” Read More...