Physician Payments to Become Public in 2013

Starting in 2013, as part of the healthcare reform legislation passed earlier this year, the public will be able to see all of the payments physicians receive from drug and  medical-device companies.

The new law, also known a the Physicians Payments Sunshine  provisions, doesn’t ban gifts to doctors, but any doctor who receives gifts over $10—including stock options, research grants, consulting fees, travel to medical conferences, to name a few—will see his or her name pop on a database that must be available to the public by Sept. 30, 2013.

“Rather than simply listing names and dollar amounts, the federal database will include explanations of what services the physicians provided in return for the payments,” according to an April 26 report from Kaiser Health News.” And drop-down menus will make it simple for patients to parse the data by name, type of gift received, and other specifics.”

To ensure this increased transparency, the new law also has some teeth. For each failure to report, fines of up to $10,000 will be applied, not to exceed $150,000 annually. For each knowing failure to report, fines of up to $100,000 will be applied, not to exceed $1 million annually, according to a fact sheet compiled by the non-partisan Pew Prescription Project.

Proponents of the measure hope that this move will reduce physician conflicts of interest and strengthen the doctor-patient relationship.  “Patients believe that FTs [financial ties] influence professional behavior and should be disclosed,” researchers reported in the April 26 issue of the Archives of Internal Medicine. "Patients, physicians, and research participants believe FTs decrease the quality of research evidence, and, for some, knowledge of FTs would affect willingness to participate in research.”

A number of states already have something similar in place. Vermont started reporting payments in 2002, and saw total payments to physicians drop 13 percent in fiscal 2009, to $2.6 million. "Last year, the state broadened the law to ban most gifts outright, including food, which accounted for $800,000 of the 2009 total,” FierceHealthcare wrote on April 26.

The new federal law, however, does not apply to other medical professionals, such as nurses and  physician assistants . This means industry money could start flowing in their direction. “In Vermont, corporate payouts to nurses totaled $288,000 in 2009—almost triple the amount they received the previous year,” according to Kaiser Health News.

In addition, critics feel doctors are unjustly made to look corrupt, and that such provisions could impede collaboration and innovation between doctors and industry. That relationship is extremely important; however, gifts are not banned under the new law, and it's hard to believe increased transparency into how industry money is spent would compromise an honest collaboration for better treatment and products.