Medicare’s Open Payments Database Brings Transparency, Controversy

There is certainly evidence that physicians can be biased by transfers of value. Indeed, these biases can be subconscious unless doctors take the time to think through them. Awareness offers some protection against undue influence. So one question to ask yourself is who benefits from the relationship. Is it you or your patients?

We want our physicians to do research—industry-sponsored research. The only ones who can develop useful new tools are the ones who use them every day in practice.
—Barbara Barnes, MD

“You should know what your data look like, why they’re there, and how to explain them,” Pierce said. Most importantly, she added, you should decide whether you want that kind of payment or not. “Are you enthusiastic about the choices you’ve made? Are you willing to talk about those choices, those interactions?” Another litmus test, said Dr. Nielsen, is to “avoid relationships or transfers of value that you’re not willing to read about in a front page news story.”

Associations such as AAO-HNS and AAMC provide their members with resources and fact sheets to help address these issues. They can also act as “firewalls” between industry and physicians, serving as middlemen in a sense, by contracting for unrestricted funds for educational and research activities, said Dr. Nielsen.

Academic medical centers have supports in place for their faculty, such as staff members who review consulting agreements and make sure they are consistent with the institution’s policy. Dr. Barnes recommends that physicians in private practice have someone else review their agreements: “What are the terms? What are you obligating yourself to?”

“This is an opportunity for physicians to acknowledge and talk about the payments they receive and [think about] why they’re important,” Pierce said.

Jill Adams is a freelance medical writer based in New York.