About two-thirds of American adults in a new national survey published in The Journal of General Internal Medicine saw a physician in 2013-2014 who had accepted industry payments within the past year, suggesting that the reach of industry payments into patient care is more extensive than previously thought.
Prior research had surveyed only physicians, finding that about 41 percent of them had received industry payments. The new research, which surveyed 1,987 respondents who could be matched to a specific physician, indicates that 65 percent of them saw a physician who had received an industry payment over the previous 12 months.
Although four out of every 10 physicians had received a payment during the 12-month period studied, almost seven in 10 respondents were seen over the same period by a physician who had received a payment.
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According to the authors, even if only a minority of physicians receive industry payments, it's still possible for much higher percentages of patients to be regularly exposed to the physicians who receive these payments. This could happen, they said, if such physicians care for more patients than those who don't accept payments, or if patients frequently visit physicians in specialities that have more industry contact, even if those specialists constitute a small part of the medical profession.
Distinguishing between patient exposure to physicians with industry contact and physician exposure to the industry is important, they said, because the reach of industry influence in clinical care could be much greater than the prevalence of payments among physicians would suggest.
The physicians patients visited also tended to have received unusually high payments. The median payment among these physicians was 1.2 to 2.7 times greater, depending on the specialty, than the median payment among all physicians in the same specialty.
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Few patients seem to know about these payments. Of the respondents, just 12 percent had heard about industry payments, and only 5 percent knew whether their own doctor had received payments. The authors expect those percentages to increase; as mandated by the Affordable Care Act, the Centers for Medicare and Medicaid Services makes this information public through its Open Payments website.
The findings were accompanied by a few policy recommendations, among them having CMS develop a one-stop-shop website on which patients could view industry payments and other information about their providers. The agency could potentially require physicians to notify their patients about this website, the authors said, much as they do with privacy provisions of the Health Insurance Portability and Accountability Act.
Payers, who also benefit from their patients being more knowledgeable about their doctors, could include industry payment information in the descriptive information they provide online about physicians in their network. Such measures would become even more important, the authors contend, if the ACA's transparency initiatives are repealed.
Twitter: @JELagasse