Center on Medicine as a Profession, Columbia University, New York, NY, United States.
Int J Law Psychiatry. 2012 Sep-Dec;35(5-6):490-5. doi: 10.1016/j.ijlp.2012.09.009. Epub 2012 Oct 2.
No one has been more effective than U.S. Senator Charles Grassley in promoting transparency in medicine. His investigations into undisclosed physician-industry ties culminated in the Physician Payments Sunshine Act (PPSA), which will make drug and device companies' payments to physicians a matter of public record. Yet it is unclear whether PPSA will resolve the problems that Grassley's campaign for it revealed.
We analyzed five signal cases, all involving psychiatrists, that Grassley presented to the U.S. Senate as examples of why PPSA was needed. We sought to determine the impact of the information Grassley brought to light on the physicians who failed to report their industry ties and on the medical institutions responsible for overseeing their conduct. Despite the clarity of the violations and the powerful actors and institutions involved, the consequences of exposure were slow to materialize and limited in their impact.
Our findings demonstrate both the need for transparency and its limitations. The medical profession and the government should use the PPSA data to verify disclosures, but they must also implement stronger conflict of interest policies to help ensure that physicians' industry ties, however transparent, do not compromise scientific integrity or patient care.
在美国，没有哪位参议员比查尔斯·格拉斯利更善于推动医学透明化。他对医生与工业界间未披露关系的调查最终促成了《医师阳光法案》（PPSA），该法案将使药企和器械公司向医生支付的款项成为公开记录。然而，目前尚不清楚 PPSA 是否能解决格拉斯利推动该法案时所揭示的问题。
我们分析了格拉斯利提交给美国参议院的五个信号案例，这些案例都涉及精神科医生，他认为这些案例是需要 PPSA 的原因。我们试图确定格拉斯利曝光的信息对那些未能报告其行业关系的医生以及对负责监督其行为的医疗机构的影响。尽管违规行为非常明确，涉及的行为人和机构也非常强大，但曝光的后果迟迟没有显现，影响也很有限。
我们的研究结果表明，透明度既需要又有限制。医疗行业和政府应该利用 PPSA 数据来核实披露信息，但他们还必须实施更有力的利益冲突政策，以帮助确保医生的行业关系，无论多么透明，都不会损害科学诚信或患者护理。
