MDNews - Greater Boston

TRANSPARENCY BETWEEN PATIENT AND PHYSICIAN HAS BECOME A WATCHWORD FOR MEDICAL REFORMERS. WHAT ARE SOME OF THE IMPLICATIONS — AND POTENTIAL BENEFITS — OF PHYSICIAN DISCLOSURE AT INDIVIDUAL AND INSTITUTIONAL LEVELS? Making the Case Physician Transparency for By Jennifer Webster T R A N S P A R E N C Y I N H E A LT H C A R E settings can take many forms: + A medical practice posts prices for offi ce visits and procedures. + A physician apologizes to a patient after making an error. + A patient has full, prompt access to her EHR. + A nurse writes his name and role on a white board in a patient's room. When it comes to data about physi- cians, political developments are turning transparency into public policy. With the Medicare transparency policy and the Physician Payment Sunshine Act, some data about physicians — gifts from phar- maceutical and medical device companies and payments from government healthcare programs — are already becoming avail- able to the public. The American Medical Association supports the Sunshine Act, though it condemns the administrative burden placed on physicians to verify their infor- mation. The AMA and other physician organizations also contend the Medicare transparency reports violate physician privacy and often contain errors or lead to misunderstanding. On the other hand, patient-advocacy g roups a nd some physicia n reform organizations advocate for increased transparency, whether that means giving patients access to physicians' clinical notes about them or having physicians provide detailed information about their beliefs, backgrounds and business relationships. An Advocate for Openness Leana Wen, MD, attending emer- gency physician at George Washington University and author of When Doctors Don't Listen, takes the debate a step further by recommending preemptive transpar- ency — physician disclosure of fi nancial relationships, ethical beliefs, political leanings and other vital information before patients request that information. "Open communication must be estab- lished by trust …," she says, recounting how she lost faith in her mother's oncologist after learning he had prescribed chemo- therapy manufactured by a company for which he was a paid speaker. "Patients should always know their doctors have their best interests at heart." A Business Case Dr. Wen created the Who's My Doctor? transparency manifesto for physicians to adopt voluntarily. However, she believes tra nspa rency ma kes good business sense for hospitals and medical practices, too. Transparency, she argues, can be an effective marketing tool: + If practices disclose Sunshine Act data preemptively, they can guide the presentation and infl uence the interpretation of the material. + Pat ient s w i l l s ele c t phy sic i a n s who are good matches for them, such a s prov iders who welcome LGBT patients. + When physicians are open about their views on topics such as end-of- life care, patients will feel freer to confi de in them. "Every argument people raise against transparency is based on fear," Dr. Wen says. "If patients know physicians were paid so much by device companies, they won't trust them. Maybe that is good. Maybe they shouldn't trust them. Sunshine is a powerful disinfectant." ■ ++++++++++++++++++++++++++++++ +++ + +++ + ++++++++++++++++++++++++++++++ PRACTICE MANAGEMENT M D N E W S . CO M ■ MD NEWS Greater Boston | 9

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