So what do these groups advocating "doctor disclosure" really want from government mandated public disclosure laws?
The answer to that question was published recently on NLARX’s (National Legislative Association on Prescription Drug Prices) website, in a slide presentation entitled: State Laws Requiring Disclosure of Gifts and Payments to Health Providers- What’s Effective and Why? by Peter Laurie of the Health Research Group at Public Citizen (one of Ralph Nader’s groups).
And, guess what we discovered? Disclosure laws are being promoted to facilitate investigative reporting by journalists.
The laws Laurie highlights require reporting "gifts" to doctors as low as $25 (Maine and Vermont) or $100 (Minnesota and West Virginia). In many instances, a "gift" is defined as anything of value and this can include any work done by a physican in collaboration with a company!
In brief, it appears Laurie and his friends believe doctors should face at least as much scrutiny (and perhaps more) than a member of the US Senate. For instance, Senators are required to report gifts aggregating more than $335, but gifts less than $134 aren’t counted!
In his presentation, Laurie defended the idea, answering the question: “Why a Doctor Gift Registry?”
First he says, it would:
-
Provide accountability and transparency to patients. ("Doctor I am dying of a heart attack, but wait let me look to see if you consulted with any companies" This is not likely to happen and I am not sure if a patient knew Doctor X consulted for a company most patients would see that as a bad thing as they would like to be seen by an expert.)
-
Restore trust in medical profession (exactly how does publishing a list of what doctors earn add to restored trust?)
-
Transparency/accountability to providers (this is to promote professional jealously, "I saw you made X.")
-
Transparency/accountability to payers (is this really in the best interest of the physician to be questioned on yet another point by CMS, the state, or their local PPO or HMO?)
-
Promotes research (esp. if names provided). (just what research does Laurie have in mind? The one type of research he mentions is another point — that the laws would: "Facilitate investigations by journalists."
Who else could use this data for research? CMS, insurance companies, even trial lawyers come to mind….!
The proposed legislation on the NLARX website, advanced in conjunction with “The Prescription Project,” would require a national, published, and continually updated list of any doctor who has received a gift as well as the type of gift. This information would be a matter of public record.
We don’t know what Laurie actually said verbally when he presented the slides, but the only point he expanded on is about journalists. Here is his next slide:
(click to enlarge)
He outlined journalistic investigations with these points:
· Comparisons by specialty
· Links to “thought leaders”
· Links to state disciplinary actions
This all sounds so innocent, except when you put it in context that this data will be used to dissuade physician inventors and researchers from collaboration with industry. I guess that means to save a few bucks we have resorted to articles in newspapers about "greedy" doctors, who are actually decent doctors devoted to bringing on board the next generation of lifesaving treatments.
Or consider that trial attorneys will use this data to include in their lawsuits all physicians involved in the creation and marketing of drugs in question. Who will want the hassle of developing and bringing to market new therapies, if people will try to ruin their lives for their effort?
In the end we will look back and wonder what trust will be restored from these initiatives?