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Patients More Likely to Visit Physicians Who Receive Larger Industry Payments

PHILADELPHIA – While most physicians said they hadn’t received any payments from industry in the last 12 months, 41% reported in a survey that they had, although the average amount was relatively small — less than $200.

A new study published in Journal of General Internal Medicine uncovered an interesting phenomenon: Patients’ exposure to physicians who receive industry payments is much higher than physician-based measures of industry contact would suggest.

A Drexel University-led study team suggests that might be because most Americans don’t know whether their own doctor has received industry payments and aren’t aware that payment information is publicly available. Results of the study indicate that about 65% of patients surveyed visited a physician within the last year who had received payments or gifts from pharmaceutical or medical device companies, and only 5% were aware of it.

"These findings tell us that if you thought that your doctor was not receiving any money from industry, you're most likely mistaken," said lead author Genevieve Pham-Kanter, PhD, an assistant professor in Drexel's Dornsife School of Public Health, who added that which practices got how much money did not appear to be random.

For the study, researchers conducted a nationally representative survey of more than 3,500 adults in the fall of 2014. Some information already was available from Minnesota, Massachusetts, and Vermont. Along with data released shortly thereafter on Open Payments — a government website established as part of the Affordable Care Act that reports pharmaceutical and device industry remuneration to clinicians — the study team linked results to data on the physicians who were visited.

They found that patients who sought certain types of specialty care were more like to see a doctor who had received industry payment, including 85% of those visiting orthopedic surgeons and 77% of those visiting an obstetrician or gynecologist.

Across the six most frequently visited specialties, patient contact with physicians who had received an industry payment ranged from 60% to 85% even though the percentage of physicians with industry contact in these specialties was much lower, ranging from 35% to 56%. At the same time, only 12% of survey respondents knew that payment information was publicly available, and less than half of that percentage knew whether the specific doctor they visited had received payments.

Based on Open Payments data, all physicians averaged $193 in payments and gifts, but, when the researchers focused only the doctors visited by participants in the survey, the median payment amount over the last year was $510, more than two-and-a-half times the U.S. average.

In the three states where information was available before the Open Payments website went online, patients were about half as likely to see physicians who received payments as patients in other states — 34% vs. 66%.

"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," Pham-Kanter said.


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