August 26 2013
Just What the Doctor Didn't Order: More Paperwork
Patrice J. Lee
Who doesn’t like sunshine? It’s a good thing. But –as we’ve learned– too much of it can be dangerous. You can get sunburn at best and cancer at worse. Similarly, people like the idea of transparency, but often overlook the added costs and unintended consequences of added (unnecessary) reporting.
A provision of ObamaCare called the Physician Sunshine Act, which kicked in at the beginning of this month, now requires doctors and medical companies to disclose all of their dealings from office visits by sales reps to speaker fees paid to doctors for appearances at conferences. What this amounts to is reams and reams of extra “paperwork” for doctors to manage robbing them of time with their patients. And it will make it that much more difficult for sales reps to meet their targets.
The mechanics are daunting. Companies must record nearly every transaction with individual doctors to a federal health agency which will post it on a searchable, public website beginning in September 2014. Doctors can review the data and work with companies to make any corrections before it is made public.
This greater disclosure will likely discourage doctors from interacting with medical and pharmaceutical companies out privacy concerns, worries about the accuracy of the information collected and backlash from perceived bias. Numbers on a screen don’t always tell the whole story.
Consumer advocates are cheering this measure. They favor openness charging that medical and pharma companies spend “large amounts of money” to influence the choices of doctors.
"The idea is that transparency will encourage doctors to evaluate whether these are appropriate relationships with companies or not," said Daniel Carlat, a psychiatrist and director of the prescription project at the Pew Charitable Trusts, which supported the Sunshine Act. He expects patients won't have much of a problem if their doctors receive $200 worth of company-provided lunches, but may question doctors who receive tens or hundreds of thousands of dollars from the industry annually.
But doctors take issue with this claim and the see this regulation as burdensome:
“We want to spend our time seeing patients, not doing paperwork,” said Dr. Jason Mitchell, the director of the Center for Health IT at the American Academy for Family Physicians.
Mitchell, who is also a practicing family physician in Missouri, does not anticipate many immediate changes for doctors — aside from fewer lunches with pharmaceutical representatives.
He predicts that because of the increased attention placed on these small meetings that make up a majority of the reportable interactions, doctors likely will shy away from them — which could be problematic. If doctors minimize their working relationships with pharmaceutical and medical representatives, their knowledge could be “less of a resource,” Mitchell said. It's important for doctors to keep up with drug and product information in other ways, he added.
We are often skeptical of new added government regulation on private industry. Sunshine laws have cropped up in a variety of industries including philanthropy and, unfortunately, have been used for sinister ends. Sunshine is a good disinfectant for wrong doing but when little or no evidence exists, it is an unnecessary infringement on privacy and adds extra costs to the bottom line. Washington policymakers neglect these unintended consequences.
Companies pass costs along to us consumers in the form of higher prices. So you can probably look forward to higher costs of medication, medical devices and medical care. And, if doctors are passing up on opportunities to learn about new medications and breakthrough devices that improve treatments and patients’ health, we all lose.