In 2015, approximately 48% of US physicians were reported to have received a total of $2.4 billion in industry-related payments.1 Patients’ trust in their treating physician is critical in fostering patient–physician relationships. However, several studies have indicated that trust is eroded whenever there is a financial relationship between physicians and industry. These undisclosed relationships may impact treatment decisions and drive up healthcare costs due to overutilization.2
Trust is difficult to measure. However, in this randomized experimental evaluation, Hwong et al. attempted to measure patient trust ratings (honesty, fidelity, competence, global trust) for physicians, the medical profession, and industry, utilizing various trust scales. The authors chose ProPublica’s website and divided participants into four study arms to view physicians who received no payment, low payments, or high payments from industry, or physicians who provided no disclosure.3
Only 278 English-speaking adults participated and were given the names of senior male physicians practicing internal medicine in Massachusetts. Only 19 participants found their own doctors listed on the disclosure website. Interestingly, the authors found that disclosure did not affect trust ratings for the medical profession or the industry. However, the ratings for honesty and fidelity decreased as the payment amount increased. Additionally, there were no differences between disclosure and no disclosure arms for any trust dimensions for the medical profession or industry.3
The Physician Payments Sunshine Act mandates public disclosure of all industry payments to physicians, and has resulted in greater scrutiny of industry’s relationship with physicians; however, payments to nurse practitioners and physician assistants are not covered.4
Despite several limitations, including small sample size and limited availability of data within the ProPublica website, this study does add limited value to the growing body of literature on payment disclosures by physicians in various specialties. The study did not address the question of whether the public will continue their relationships with their providers after learning of their payments from industry. The influence of conflict of interest disclosures available on pubic websites, adherence to institutional policies, and patient–physician relationships requires further research and should include other caregivers, including mid-level providers.
Compliance with Ethical Standards
Conflict of Interest
The author has no conflicts of interest with this article.
References
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