Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA.
Biostatistics and Epidemiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Int J Health Policy Manag. 2018 Feb 1;7(2):112-119. doi: 10.15171/ijhpm.2017.128.
Financial conflicts of interest exist between industry and physicians, and these relationships have the power to influence physicians' medical practice. Transparency about conflicts matters for ensuring adequate informed consent, controlling healthcare expenditure, and encouraging physicians' reflection on professionalism. The US Centers for Medicare & Medicaid Services (CMS) launched the Open Payments Program (OPP) to publicly disclose and bring transparency to the relationships between industry and physicians in the United States. We set out to explore user awareness of the database and the ease of accessibility to disclosed information, however, as we show, both awareness and actual use are very low. Two practical policies can greatly enhance its intended function and help alleviate ethical tension. The first is to provide data for individual physicians not merely in absolute terms, but in meaningful context, that is, in relation to the zip code, city, and state averages. The second increases access to the OPP dataset by adding hyperlinks from physicians' professional websites directly to their Open Payments disclosure pages. These changes considerably improve transparency and the utility of available data, and can furthermore enhance professionalism and accountability by encouraging physicians to reflect more actively on their own practices.
存在医药行业与医生之间的财务利益冲突，这些关系有能力影响医生的医疗实践。透明度对于确保充分的知情同意、控制医疗支出和鼓励医生对专业精神进行反思很重要。美国医疗保险和医疗补助服务中心（CMS）启动了公开支付计划（OPP），旨在公开披露并提高美国医药行业与医生之间关系的透明度。我们旨在探讨用户对该数据库的认识和获取公开信息的便捷程度，但事实证明，用户的认识和实际使用都非常低。两项实用政策可以极大地增强其预期功能，并有助于缓解伦理紧张局势。第一项政策是，不仅要按绝对值，而且要按有意义的背景（即与邮政编码、城市和州平均值相关联）向单个医生提供数据。第二项政策是通过在医生的专业网站上添加到其公开支付披露页面的超链接，增加对 OPP 数据集的访问。这些变化大大提高了透明度和现有数据的实用性，并且可以通过鼓励医生更积极地反思自己的实践来提高专业精神和问责制。
