“We require disclosure of all relationships, including those that are more of a civic activity, along with those that involve industry or research,” he said.
Before the Open Payments disclosures, some medical-industry payment data were made public through a patchwork of state laws, voluntary reporting by manufacturers and corporate-integrity agreements requiring drug or device companies to disclose payments made to physicians. ProPublica, an investigative news site, in 2010 launched an online tool that compiles payment information disclosed by 15 companies.
Advocates of the Sunshine Act hope the disclosure of industry payments will foster a new era of transparency that curtails inappropriate use of drugs, products and other services arising from doctors' financial self-interest.
But physician and hospital groups and other industry organizations, which have been critical of the CMS' handling of the data and the website, are apprehensive about how the media will cover the Open Payments data, and whether the information will be accurately understood by the public. Those fears were exacerbated by media coverage of Medicare's release of information on payments to individual physicians this year.
There are likely to be media stories about which doctors and which medical specialties receive the most money from manufacturers. Hospitals and physicians may have to field questions about potential conflicts from reporters, patients, researchers, insurers, regulators and fraud investigators, and may be forced to explain, defend and put into context the societal benefits of receiving funding. “A lot of patients don't understand the role that individual doctors may have in supporting a clinical trial,” said Mark Senak, a partner with public-relations agency FleishmanHillard.
To prepare for the data release on Tuesday, the University of Iowa Hospitals and Clinics, a 685-bed academic medical center in Iowa City, has developed a list of frequently asked questions for the media and patients who ask about disclosed payments, said Debbie Thoman, the hospital's assistant vice president for compliance and accreditation. The university plans to use the database to confirm payment data provided by its physicians. The university has required disclosures from its physicians since it established its conflict-of-interest policy in 2009.
Dr. Leana Wen, an emergency room physician who last year founded the “Who's My Doctor?” group, said physicians should be proactive about discussing what payments they received with their patients. Sending a letter to patients or posting an explanation in the waiting room are ways that physicians can do this. “This will begin the dialogue between patients and doctors about financial disclosure,” she said.
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