US Nationwide Disclosure of Industry Payments and Public Trust in Physicians
Open accessAbstract
Importance: Transparency of industry payments to physicians could engender greater public trust in physicians but might also lead to greater mistrust of physicians and the medical profession, adversely affecting the patient-physician relationship. Objective: To examine the association between nationwide public disclosure of industry payments and Americans' trust in their physicians and trust in the medical profession. Design, Setting, and Participants: Survey study using difference-in-difference analyses of a national longitudinal survey comparing changes in states where industry payments were newly disclosed by Open Payments with changes in states where payments information was already available because of state sunshine laws. The US population-based surveys were conducted in September 2014-shortly before the initial public disclosure of industry payments-and again in September 2016. Final analyses were conducted September through December 2018. Participants were adults 18 years and older (n = 1388). Exposures: National public disclosure through Open Payments of payments made by pharmaceutical and medical device firms to physicians. Main Outcomes and Measures: Wake Forest measure of trust in one's own physician and Wake Forest measure of trust in the medical profession. Results: Of the 3542 original survey respondents, 2180 (61.5%) completed the second survey 2 years later, and 1388 named the same most frequently seen physician in both surveys. The mean age of respondents at the time of the first survey was 53 years, and 749 (54.0%) were women. Race/ethnicity was white in 76.6% (1063 of 1388) and non-Hispanic black in 8.0% (111 of 1388). Public disclosure of payments was associated with lower trust in one's own physician regardless of whether respondents knew their physicians had received payments (decrease in Wake Forest measure of trust in one's own physician of 0.56 point; 95% CI, -0.79 to -0.32 point; P < .001). Open Payments was also associated with lower trust in the medical profession (decrease in Wake Forest measure of trust in the medical profession of 0.35 point; 95% CI, -0.58 to -0.12 point; P = .004). Conclusions and Relevance: Nationwide public disclosure of industry payments may be associated with decreased trust in physicians and in the medical profession. More judicious presentation of payments information may counteract unintended negative trust and spillover consequences of public disclosure.
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Conflict of interest disclosure may actually decrease trust by making patients more aware of relationships between their physicians and pharmaceutical companies.
“However, CoI disclosure may actually decrease trust, as it may make patients more aware of the relationships between their physicians and pharmaceutical companies 263,264 .”
From Ethical challenges in contemporary psychiatry: an overview and an appraisal of possible strategies and research needs (2024) · cites this paper as [264]
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- Authors
- Kanter, G. P., Carpenter, D., Lehmann, L. S., & Mello, M. M.
- Affiliations
- Leonard Davis Institute of Health Economics (US)
- Harvard University (US)
- Veterans Health Administration (US)
- Stanford Medicine (US)
- Corresponding author
- Kanter, Genevieve P.
- Venue
- JAMA Network Open
- Publisher
- American Medical Association (AMA)
- Published
- 2019-04-12
- Volume
- 2
- Issue
- 4
- Pages
- e191947
- ISSN
- 2574-3805 (ISSN-L)
- PMC
- PMC6481437
- OpenAlex
- W2936776369
- Cited by
- 64
- References
- 30
- Citations by year
- 2026: 6 · 2025: 13 · 2024: 9 · 2023: 10 · 2022: 5 · 2021: 8 · 2020: 12 · 2019: 1
- FWCI
- 6.55
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JAMA Network Open (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Greenwall Foundation
- Topics
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmaceutical industry and healthcare
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Global Public Health Policies and Epidemiology
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Keywords
- physician-industry payments, Open Payments, trust in physicians, sunshine laws, pharmaceutical industry, medical device industry, physician-patient relationship, transparency
- MeSH terms
- Professionalism, Adult, Drug Industry, Ethnicity, Female, Humans, Male, Middle Aged, Physician-Patient Relations, Physicians, Surveys and Questionnaires, United States, Disclosure, Trust
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