Approximately one year from now, "manufacturers of drugs, devices, biologicals, or medical supplies covered by Medicare, Medicaid or the Children's Health Insurance Program (CHIP)" will be required to report "certain payments or transfers of value" to medical physicians and hospitals.
This new requirement, which comes courtesy of a rule issued by the Centers for Medicare & Medicaid Services (CMS) on Feb. 8, 2013, specifies that "applicable manufacturers' and applicable GPOs' [group purchasing organizations] submitted payment and ownership information" be published on a public Web site. Every patient will then be able to see just how much money their medical doctor / hospital gets – and from whom.
This information should prove to be very enlightening for patients who take the time to do a little investigating about the medical doctor they are going to trust with their health. In the case of a family practitioner, patients may discover that their medical doctor has received hundreds of thousands of dollars for "research" and "speaking" from the manufacturers of the drugs the doctor prescribes. A patient seeing an orthopedic surgeon might be surprised to discover the high rate of surgeries their doctor recommends and the seemingly commensurate large payments by device companies that just happen to make the devices used in the surgeries. In many cases, the conclusion will be obvious.
The final numbers are expected to be quite startling for those who don't appreciate just how deep the financial relationship is between the drug / device companies and the medical profession. The compensation will easily be in the billions of dollars per year.
One website already provides a list of how much money was paid by a few drug companies, noting: "Drug companies have long kept secret details of the payments they make to doctors and other health professionals for promoting their drugs. But 12 companies have begun publicizing the information, some because of legal settlements." This online database "includes more than $760 million in payments from 12 pharmaceutical companies to physicians and other health-care providers for consulting, speaking, research and expenses."2
Once the financial details are finally published, you will want to review the information on the medical doctors and hospitals in your community. You may want to create a list of the worst offenders (highest paid) and who is financing their practice. Needless to say, you will want to think twice before referring doctors or hospitals whose health care decisions may be driven by financial incentives, not just good patient care.
Having this information on the web will create a great opportunity to educate your patients about potential conflicts of interest and possibly answer questions such as, "Why did my medical doctor prescribe four drugs when my blood pressure only increased a little?" or "I met with a surgeon about my back pain and he is really pushing me hard to have surgery; do you think I need a second opinion?"
Health care is supposed to be focused on the best, most appropriate care for the specific patient. But money can erode good intentions and create conflicts of interest, especially when the dollar amount reaches six figures or more.
When the financial disclosures are finally online, every patient should spend some time reviewing the data on their medical providers, as well as their local / affiliated hospitals. They need to know who is paying their doctor / hospital and how much money is involved, and understand how these potential conflicts of interest can impact the recommendations / prescriptions they receive.
You can play a role in creating awareness among your patients and your community. You can help shed a bright light that will hopefully force medical doctors and hospitals to make more appropriate decisions for their patients and ultimately reduce the unnecessary prescriptions and surgeries. Stay tuned for specific information as it becomes available. We will certainly be reporting more on this.
References
- "Medicare, Medicaid, Children's Health Insurance Programs; Transparency Reports and Reporting of Physician Ownership or Investment Interests." Centers for Medicare & Medicaid Services (CMS). Published in the Federal Register on Feb. 8, 2013.
- ProPublica.com: "Dollars for Docs: How Industry Dollars Reach Your Doctors." http://projects.propublica.org/docdollars/
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Click here for more information about Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher.