A study published in the Journal of General Internal Medicine revealed a shocking statistic: 65 percent of American patients put their health in the hands of doctors who may be in the pharmaceutical industry’s pockets. The physicians in question, the study found, had received at least one payment from a drug or medical device maker over the last 12 months. Moreover, only 5 percent of the 3,542 adult patients surveyed knew that their doctors had ties to the industry.
The study’s primary author, Genevieve Pham-Kanter, is an Assistant Professor at Drexel University. Among many revealing observations, she stated that the study’s findings “suggest that although physicians who accept industry payments are in the minority, they are caring for a very substantial portion of America’s adult patient population.”
The industry’s tactics to influence medical care and research are well known. Over the last decade, there have been many efforts to increase transparency so that patients can make better-informed decisions about their treatments and the physicians they choose. The Affordable Care Act was an important milestone on the path towards increased accountability. As part of the Act, the Open Payments site was created to disclose information about industry payments to physicians.
According to the study’s authors, Obamacare’s initiative to make this information public was “motivated in part by concerns that industry payments could lead physicians to make decisions that were not in the best interest of their patients, and that patients ought to be able to choose physicians and make medical decisions with this knowledge about industry payments in mind.”
Based on Open Payments data, about 40 percent of doctors receive payments from the industry, but there are significant variations by specialty. Some of the most problematic areas are orthopedics and cardiology, with an 80-90% rate of disclosed industry payments.
These numbers are shocking enough, but the Drexel study has also shown that doctors who receive incentives from drug and medical device makers are more likely to see patients. For example, while 47 percent of obstetricians/gynecologists have industry ties, 77 percent of patients who saw one of them, saw a specialist with industry ties. And the physicians seen by survey participants received significantly higher industry payments than the average doctor.
Nearly half of the survey respondents were aware that doctors received money from the industry; only 5 percent of them said they knew their own physicians had received payments. Interestingly enough, 70 percent said they were certain that their doctor had not been paid, but over 40 percent were wrong based on the industry’s public disclosures.
The study’s authors have suggested several policy changes that could increase transparency—for example, requiring doctors to disclose industry payments to their patients and requiring companies to disclose payments to doctors on their corporate websites.
In a statement, Pham-Kanter emphasized the importance of the problem. “We may be lulled into thinking this isn’t a big deal because the average payment amount across all doctors is low. But that obscures the fact that most people are seeing doctors who receive the largest payments,” the study’s author said. “Transparency can act as a deterrent for doctors to refrain from behaviors that reflect badly on them and are also not good for their patients,” she concluded.