What's the real extent of industry payments to doctors?
More than three in every five Americans see a doctor who receives some form of payment from industry. This is according to a new survey led by Genevieve Pham-Kanter of Drexel University's Dornsife School of Public Health in the US. It is the first nationally representative study to examine the prevalence of industry payments among the general population of patients. The survey in the Journal of General Internal Medicine, published by Springer, also shows that very few Americans know whether their own doctor in fact received industry-backed payments or gifts, or that such information is publicly available.
The survey was done in light of the Patient Protection and Affordable Care Act, which addresses concerns that industry payments could lead physicians to make decisions that are not in the best interest of their patients. Since 2013 the Act requires pharmaceutical and medical device manufacturers to report gifts and payments they make to healthcare providers. This information is publicly available on the Centers for Medicare and Medicaid Services' Open Payments website.
The survey was done shortly before the first release of the Open Payments data in September 2014. A short online survey was completed by 3,542 adults. They were asked whether they were aware of industry payments, and to name the physicians they had seen most frequently in the previous year. These names were then linked to the Open Payment data to ascertain how often patients saw doctors who accepted industry payments.
The survey highlighted that 65 percent of respondents had visited a physician who accepted an industry payment. This was particularly the case for those visiting family medicine physicians (63 percent) and obstetricians and gynecologists (77 percent).
Despite respondents' extensive contact with physicians who receive industry payments, only 45 percent reported knowing about this practice. Twelve percent of respondents knew that information about such payments was publically available, while only 5 percent actually knew if their doctors received industry favors.
Pham-Kanter says previous studies among physicians have underestimated how much contact patients have with industry. The latest survey shows that although only four out of every ten doctors had received a payment during the course of one year, almost seven out of ten respondents were seen, over the same period, by a physician who benefited from such payments. The doctors whom patients visited also tended to have received unusually high payments well above the norm.
"The 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," explains Pham-Kanter, who believes the results most likely underestimate Americans' exposure to doctors with industry ties.
"Drug and device companies tend to pursue relationships with key opinion leaders in medicine because of these leaders' potential to influence the clinical practice of others, even those who themselves do not accept industry payments," she adds.