The dark side of the Physician Payment Sunshine Act

Another seemingly harmless bureaucratic initiative aimed at physicians sunk its taproot deep in the daily workings of medicine recently. The Physician Payment Sunshine Act promises transparency in all industry dealings with physicians by shedding light on the issue of payments to physicians from pharmaceutical companies and medical device manufacturers. In turn, it will save the system money, since all those freebies bestowed upon physicians when the corporate world came knocking can now be accounted for and physicians will be shamed into proper behavior.

Meanwhile, back at the drug company headquarters, some poor schnook gets to type all the names of the nurses and technicians that enjoyed their meal from the echo lab, cath lab, stress testing lab and were asked to place their name on a sign-in list so it can be entered on a multi-million dollar database designed to feed the government big data bosom in the sky.  Busy doctors dart in, grab a bite, and go.

No need for them to sign-in.

You see, it’s a bad marketing strategy to ask a doctor to sign a form as you peddle your product. And since no one is monitoring the accuracy of the sign-in sheets, as they have a few names to justify their effort and expense, well, they’ve done their part.

Why is this expensive data collection charade taking place? How much does it cost us? Does it change pharmaceutical tactics for marketing to doctors?   Of course not.  Yet there remain central planners who remain convinced that such monitoring works. It’s a classic wish: just like the government’s Hospital Compare website, which promises to collect data on readmission, pneumonia, infection and death rates in the hopes that people will make smart choices about their health care.

Do people really make their choice of health care facility based on such poorly-collected data placed on a website? I don’t think so. Most people never think about their health until they have to arrive in an emergency room blindsided by an unexpected health crisis. They are not checking websites about payments to doctors — especially websites set up by the government. They want access to their local health care system and prompt, quality care.

Yet were we are once again using big data filled with bad data as an ill-conceived and expensive social engineering exercise.  And this cost is passed on to health care consumers. In short, it’s another perfect storm of wasted resources in the practice of medicine.

“But Dr. Wes, how can you say such a thing? Can’t you see this Sunshine Act developed by Congress as part of the Affordable Care Act will disclose all of those greedy physicians who want to suck the health care system dry of all of that money? Aren’t there benefits to the public transparency of these payments?”

The irony of this whole law is that Big Pharma and Big Medical Device Company already report the money they give doctors to the government via the IRS in the form of a 1099-MISC. (Recall that the IRS is now firmly a part of our new health care law).  But instead of looking deep within the bureaucratic governmental morass for solutions to physician payments from industry, a new knee-jerk law was enacted to parade before the press to show how sincere the medical device companies and pharmaceutical companies are about the need for such transparency. Meanwhile, it’s business as usual as backroom pricing of drugs and devices continues.

War room strategists have known this policy tactic for years: it’s called diversion. Collect data on every $20 dollar physician lunch handout as our new breed of physician-employers negotiate sweet deals with their insurance pals, prices of hospital system charge masters edge ever higher, drug prices and device charges continue to exceed tens of thousands of dollars thanks to Medicare payments, and insurance companies offer health plans rather than insurance to their policy holders.  And let’s not even talk about the favors our Congressmen and Congresswomen are afforded.

But then again, better to put doctors in the limelight rather than speak honestly of the pricing games taking place behind American’s backs, right?

Wes Fisher is a cardiologist who blogs at Dr. Wes.

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