About two years ago I was contacted by an Iowa physician who shared his concern about an Iowa doctor’s potential conflict of interest. The doctor was receiving third-party financial compensation which, quite possibly, was putting the best interest of his patients at risk.
Within both articles, I summarized that medical providers should post on their websites the financial interests they have with third parties, such as drug and medical device companies. Being ethical and transparent with patients and the public about any third-party relationship is not optional in medicine – it is essential. The most important duty of any physician is to act in the best interest of the patient. Informed consent should always apply within the physician-patient relationship.
Unfortunately, Iowa does not require doctors to be transparent with the public and their patients. For now, Iowans must rely on a little-known website, OpenPaymentsData.CMS.gov, to learn whether their doctor (or teaching hospital) has received payments and other transfers of value from drug and medical device companies. Most people are not aware of the important information found in OpenPayments, which is a website established by the Centers for Medicaid and Medicare Services (CMS).
Medical Device Firms Outspend Drug Firms
According to researchers at the University of Pennsylvania and Columbia business schools, medical device firms paid, on average, $904 million a year to nearly 200,000 surgeons and other doctors who use their products. This payment is estimated to be 1.7 percent of total industry revenue. In comparison, the much larger drug industry paid, on average, $821 million a year to over 300,000 physicians, which was less than one percent of industry revenue. The period of time researched was 2014-17. This information comes from a new study in the April edition of Health Affairs.
California is deciding on a bill that addresses any potential conflict of interest that doctors may have.
California – Assembly Bill 1278
Largely due to the persistence of a harmed patient, Wendy Knecht, along with the initiative of her state assembly member, AB1278 was introduced into the California legislature on February 19. AB1278 will require physicians and surgeons to disclose the source of payments given to them by drug and device companies, in addition to promoting patients’ knowledge of the CMS OpenPayments website resources.
Under the bill requirements, physicians and surgeons must post an OpenPayments database notice in each location where the physician/surgeon practices and in an area that is likely to be seen by all persons who enter the office. Additionally, OpenPayments database notice must be clearly posted on the internet website used for the physician and surgeon’s practice. As stated by this bill: A violation of the bill’s provisions would constitute unprofessional conduct.
Due to minimal efforts to educate the public about CMS OpenPayments, many Americans – including doctors – are not aware this resource exists. Too often, the onus is on the patient to do the research and locate this website. Thanks to Wendy’s efforts, there is now a reference to OpenPayments on the CA Medical Board website. Unfortunately, there is no reference to OpenPayments on the Iowa Medical Board (IMB) website.
Similar Legislation for Iowa?
The mission of state medical boards should deem this to be an essential public service to Iowans. For the record, I have requested IMB to determine their willingness to post this information. As of the publication of this blog, I have not heard back from IMB.
A federal law would make sense. In the meantime, a similar bill should be introduced in the 2022 Iowa legislative session. Finding a sponsor should not be difficult and both political parties would hopefully agree this language transcends party affiliation.
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