What New Legislation About Physician-Industry Relationships Means to You

Exploring how the ‘Sunshine Act’ could affect patient care

Sunshine Act

As a health care consumer, there are important details that you should know about a well-intentioned but misguided piece of legislation — the Physicians Payments Sunshine Act.

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This legislation is a lesser known part of the Affordable Health Care Act (or what we know as “Obamacare”). The act requires drug, medical device and biological companies to report payments and gifts they give to doctors and teaching hospitals.

Designed to bring greater transparency to the medical field, it is a response to concerns about relationships between physicians and pharmaceutical and medical device companies and was sponsored by Senators Charles Grassley (R-IA) and Herb Kohl (D-WI).

Under the requirements of the act, any drug or device manufacturer must report payments or transfers of value to physicians and teaching hospitals or any doctors providing care in a teaching hospital. The reporting includes anything at least $10 in value.

The initial reporting under the act has begun already and you can review these payments on a federal website – http://cms.gov/openpayments/ .

What’s in the details

Certainly, any possible impact on patient safety needs scrutiny. It is important to examine how these industry relationships could impact the way physicians treat their patients – potentially affecting choices for specific medical implants for example.

However, the data that drove this legislation needs careful consideration as well.

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While research finds that more than 85 percent of physicians had some form of financial relationship or support from industry, it is important to recognize that more than two-thirds of these payments were for less than $100.

Gifts often include trivial things, such as a drug company representative purchasing a cup of coffee or a pen for a physician in order to highlight a certain drug or prescription agent.

At the same time, a few individual physicians may receive millions of dollars for intellectual property or ownership in a company. It’s difficult to put all of these situations into one bucket when talking about the impact of industry relationships.

A closer look at industry relationships

It is also important to recognize that just as a physician’s industry relationships have the potential to affect patients negatively, they can also offer many benefits that ultimately are good for patients.

The more active a physician is, the more likely drug or device companies want and need their input to define clinical needs and explore ideas for studying drugs and devices. The relationship often indicates a physician’s experience and clinical strength while helping improve the design and effectiveness of medical devices and drugs.

All physicians must manage the potential conflicts from these relationships. Also, leading institutions will have conflict of interest management strategies to assure physicians maintain the ability to care for their patients, remain engaged with industry and provide this care in such a way that assures they are choosing the best possible options for their patients.

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Conflict of interest

Clearly there are some aspects of industry relationships hold the potential for conflict of interest and the public should be made aware.

In most instances, patients trust physicians to provide some information regarding their relationships, but sometimes, this information has not been provided. It’s become evident that patients need clarity about the exact nature of relationships (including the amount being given).

Ultimately, identifying a physician to care for you depends upon your sense of confidence, and this is more a reflection of experience the physician has in dealing with your problem.

In many instances, this will be the same physician a pharmaceutical or medical device company will want to partner with to devise the next drug or device to deal with significant medical problems.

Health care organizations do well to maintain transparency and a strategy for conflict management. For example, Cleveland Clinic publishes physicians’ industry relationships on its website.

The experience physicians acquire at this institution makes them frequent partners for industry and experts in their individual fields. Ultimately, this can lead to innovation and better, newer treatments for patients.

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