Disclosure of financial relationships between clinicians and industry has long been a priority for consumer advocates, who worry about unseen incentives that may influence prescribing decisions, the use of high-tech tests and even surgical procedures.
The Open Payments program was required by President Barack Obama's health care law, but for now it's not easy to pry loose the data.
It is still possible to launch a search on particular doctor's name, after a number of steps. But after that a consumer has to combine several data categories to get a complete picture, including gifts, research grants and ownership stakes.
Basic instructions: On the home page, hover over "Explore the Data." Click on "Data Explorer." Click on "Access the Data Explorer Tool." Look for the file called "General Payment Data," and click on that. When the file opens, look for a filter screen to appear and enter the doctor's name and other identifying information. Another six steps are needed to get the total value of industry benefits for that doctor.
Even tech nerds who downloaded the underlying trove of detailed records have run into challenges.
Many industry payments to physicians are hidden from public view, according to AP's analysis of the data, which includes more than 4 million transactions from August through December 2013.
The same is true for payments to teaching hospitals, also captured by the database.
- Nearly 40% of the $74 million in industry-paid travel for clinicians did not document the name of the individual provider receiving the benefit. The travel records — revealing choice destinations like New York, Paris and Amsterdam — instead show "XXs" where the doctor's name is supposed to be listed. Officials say that's because of unresolved questions about the accuracy of some of the data.
- Almost all of the $1.43 billion in research grants to teaching hospitals did not list the name of the institution receiving the money. Only $108 million in research grants listed the names of hospitals, including Boston's Dana-Farber Cancer Institute and Houston's MD Anderson Cancer Center. Again, that's because of disputes over the data that industry reported to the government. Doctors and hospitals were allowed to review the information before its release.
Consumer groups and lawmakers who support the program are urging patience.
"Yes, this is confusing right now, but it is a lot better than ignorance," said John Santa, medical director for health projects with Consumer Reports. "Out of confusion comes knowledge. I am confident that will happen here."
Others are not so sure. The American Medical Association is worried that doctors' reputations will be tarnished if their names turn up on a list next to drug company dollars. Some worry it will deter physicians from participating in clinical trials, which can provide valuable knowledge to society as a whole.
Open Payments is administered by the federal Centers for Medicare and Medicaid Services, which runs those giant benefit programs as well as HealthCare.gov, the online portal to the government's newest insurance plan.
An agency official said the Open Payments improvements coming this month will allow consumers to easily search for their doctor, doctors in a community, doctors by specialty and types of payments received.