Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Should the Sunshine Act be celebrated?

Dr. Charles
Policy
July 8, 2013
304 Shares
Share
Tweet
Share

Do you want to know if your doctor has been eating pizza for lunch that was purchased by Pfizer as she listened to a drug rep describe a new medication? Do you want to know if your endocrinologist has been paid $1,500 to give a brief talk about a new injectable diabetes medication to his colleagues as they gobble down filet mignon? If the answer is “yes,” then you are in luck.

As the August 1st, 2013 deadline to start reporting information about these sorts of transactions approaches, doctors and hospitals are reevaluating whether a free tray of chicken salad wraps is worth the scrutiny.

The Sunshine Act, a provision of the Affordable Care Act (aka Obamacare), requires companies that make drugs, medical devices, and biological medicines to report payments and items of value given to physicians and teaching hospitals. (specifics outlined by NEJM and AMA)

Additionally manufacturers and group purchasing organizations must report certain ownership interests held by physicians and their immediate family members. It seems like physicians who own stock in a publicly traded pharmaceutical company do not have to report these shares, as they are generally available to everyone and are considered an “exempt” interest. But other terms of ownership and investment interest must be disclosed, including the dollar amount.

A transfer of anything between a company and a physician that has a value above $10 must be reported. Cumulative gifts totaling $100 or more over a year must be reported.

(One way a sneaky physician might find a loophole in this regard would be to ask the drug rep who comes to the office for a lunch time meeting to bring just one hot dog, valued at $9.99. This would fly under the radar… at least 10 times per year – but if the total cost of the hot dogs brought into the doctor’s office exceeds $100 for the year, said hot dogs must be reported. One could then log on to the Medicare website and see how the 11 hot dogs your doctor ate over the year totaled $109.89, which carries multiple degrees of shame.)

The Sunshine Act will expose or stop many physicians from making additional money through relationships with manufacturers that represent a conflict of interest.

It will also represent another dreadful use of the word “sunshine,” and makes for great irony as our government increasingly operates in darkness.

The threat of public shame and public misunderstanding will also create fear among physicians, and new treatments and medications will go unnoticed without the occasional lunch used by drug reps and physicians to communicate.

I’m looking forward to less patients assuming I go golfing for free, or thinking I get taken to Las Vegas for a free convention every year.  This has been outlawed for some time.

Office morale will plummet in many locations that used to host drug reps for lunches, occasionally or daily. The medical assistant who used to look forward to getting a free eggplant parm with arugula salad once a week (as her doctor learned about a new blood pressure medication) may now be upset. A lot of mom and pop restaurants will see fewer business lunches purchased by drug reps, and more fancy dinner venues will see a decline as well.

In any other facet of the American economy, the “business lunch” is revered as an opportunity for communication, networking, and an exchange of new ideas. In medicine it has been cast as a seedy chance for manipulation, kickbacks, and brainwashing, and is now subject to the sanitizing UV radiation of “sunshine.”

If we as physicians are to be held to such monastic, ascetic terms of engagement with the business community, then fine. I’m all for keeping drug reps carrying trays of chicken nuggets away from the office.  I’m all for those few specialists and physicians who are much too cozy with pharmaceutical companies getting the public scrutiny of their speaking fees and other arrangements. But then everyone else butt out, too.

Insurance companies paying CEO’s hundreds of millions, malpractice clients and their lawyers getting paid millions, overpaid health care administrators emulating corporations, and third party profiteers of all stripes … everyone out.

The examining room should be about a doctor and a patient, with the unfortunate reality of the economic exchange feeling no more corrupt than payment for a bag full of groceries.

“Dr. Charles” is a family physician who blogs at The Examining Room of Dr. Charles and The Green Examining Room. 

Prev

How Katie Couric continues to influence the colonoscopy debate

July 8, 2013 Kevin 8
…
Next

When does a teen girl need a pelvic exam?

July 8, 2013 Kevin 23
…

Tagged as: Medications, Primary Care

Post navigation

< Previous Post
How Katie Couric continues to influence the colonoscopy debate
Next Post >
When does a teen girl need a pelvic exam?

More by Dr. Charles

  • a desk with keyboard and ipad with the kevinmd logo

    The disturbing link between high fructose corn syrup and honey

    Dr. Charles
  • Why a Miracle Whip advertisement is offensive

    Dr. Charles
  • a desk with keyboard and ipad with the kevinmd logo

    Beware of that new car smell when shopping for a new car

    Dr. Charles

More in Policy

  • Why the WHO’s pandemic accord is critical for global health care

    Elizabeth Métraux
  • The revolutionary Kaiser-Geisinger deal: How health care giants are reshaping the industry and empowering patients

    Robert Pearl, MD
  • Unveiling the intricate link between housing costs and health care

    Harvey Castro, MD, MBA
  • Uncovering the truth about racial health inequities in America: a book review

    John Paul Mikhaiel, MD
  • Why affirmative action is crucial for health equity and social justice in medicine

    Katrina Gipson, MD, MPH
  • The untold story of Hispanic/Latino health: Why subgroup data matters

    Matthew B. Alonso
  • Most Popular

  • Past Week

    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
  • Past 6 Months

    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
  • Recent Posts

    • Empowering Black nurses for lasting change [PODCAST]

      The Podcast by KevinMD | Podcast
    • Master time management with 7 productivity strategies for optimal results

      Farzana Hoque, MD | Physician
    • Proposed USPSTF guideline update: Advocating for earlier breast cancer screening at age 40

      Hoag Memorial Hospital Presbyterian | Conditions
    • The rising threat of lung cancer in Asian American female nonsmokers

      Alice S. Y. Lee, MD | Conditions
    • The tragic story of Mr. G: a painful journey towards understanding suicide

      William Lynes, MD | Physician
    • Healing trauma and reconnecting: Unmasking the impact of dissociation [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 6 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Novel Anti-HER2 Drugs 'Impressive' in Advanced Biliary Cancer
  • What Was Tied to Lower Long COVID Risk?
  • Chemo-Free Approach Works in Subset of Patients With HER2+ Early Breast Cancer
  • Two-Drug Combo Wins for Refractory Gout
  • First-in-Class Sjogren's Drug Passes Mid-Stage Test

Meeting Coverage

  • Novel Anti-HER2 Drugs 'Impressive' in Advanced Biliary Cancer
  • Chemo-Free Approach Works in Subset of Patients With HER2+ Early Breast Cancer
  • Two-Drug Combo Wins for Refractory Gout
  • First-in-Class Sjogren's Drug Passes Mid-Stage Test
  • Pricey Drug Combo Boosts PFS in First-Line Advanced Ovarian Cancer
  • Most Popular

  • Past Week

    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
  • Past 6 Months

    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
  • Recent Posts

    • Empowering Black nurses for lasting change [PODCAST]

      The Podcast by KevinMD | Podcast
    • Master time management with 7 productivity strategies for optimal results

      Farzana Hoque, MD | Physician
    • Proposed USPSTF guideline update: Advocating for earlier breast cancer screening at age 40

      Hoag Memorial Hospital Presbyterian | Conditions
    • The rising threat of lung cancer in Asian American female nonsmokers

      Alice S. Y. Lee, MD | Conditions
    • The tragic story of Mr. G: a painful journey towards understanding suicide

      William Lynes, MD | Physician
    • Healing trauma and reconnecting: Unmasking the impact of dissociation [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Should the Sunshine Act be celebrated?
6 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...