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

Who’s my doctor? The total transparency manifesto

Leana Wen, MD
Physician
November 8, 2013
Share
Tweet
Share

Our health care system is broken and in dire need of reform. We all know the statistics: the U.S. spends $2.7 trillion on healthcare, 30% of which is waste in the form of unnecessary tests and unnecessary treatments. Conflicts of interest are rampant, with 94% of doctors reporting an affiliation with a pharmaceutical or device manufacturing company, and many more insidious influences including salaries being tied to productivity. Dozens of studies have shown that these conflicts of interest have a real impact on care, and are a major driver of excessive cost and avoidable harm.

On my recent book tour, I discovered an even bigger problem than the cost of care. There is a rampant and growing epidemic that we seldom discuss — the epidemic of fear. It’s understandable why patients are scared when they come to us. They’re not feeling well. They’re scared of what might happen.

But there’s another layer of fear, one that begins and ends with trust. When my mother was diagnosed with metastatic cancer, it took her months to find an oncologist she liked. One day, while trying to locate his office number online, she found a listing for him as a highly-paid consultant and speaker for a drug — the same chemotherapy drug that he’d put her on. This might have still been the right treatment for her, but it made her wonder, and it made her scared.

Traditionally, medicine has maintained a certain mystique. While there has always been information asymmetry, patients and doctors established longstanding relationships, and patients trusted that doctors had their best interests at heart. However, today’s medical landscape is very different. Few patients have longstanding relationships with their doctors. They have little to go on when deciding who to trust with their health, then are kept in the dark on matters ranging from cost of care to doctors’ motivations to necessity of tests and treatments.

In a time when they are already vulnerable and scared, patients have become even more afraid that they may not be receiving the right care for the right reasons. Doctors, too, have become afraid of their patients; much has been written about the fear of malpractice leading to hiding mistakes and practicing defensive medicine.

This mutual fear has led to distrust, disconnection and poor medical care. The driver of fear is secrecy and shame, and the antidote is honesty and transparency. Doctors are public servants whose duty is to be accountable to our patients. We need to break through the barrier of fear by sharing with our patients and the public who we are.

This is why I’m starting a new campaign, “Who’s My Doctor? The Total Transparency Manifesto.” Participating doctors produce a voluntary, public disclosure statement that includes the following: revenue streams of all payments, salary contribution and how salary is determined (i.e. hourly, RVU system, incentive/bonus), paid and unpaid board membership, investments, volunteer activities, professional interests, hobbies, and philosophy of practice.

Doctors already disclose much of this information when they apply for jobs and when they submit to medical journals. So why shouldn’t this information also be available to the public? Our patients have a right to know what influences their doctors may have that affect their care. It holds doctors accountable to our patients while at the same time humanizing us and reinforcing our role as socially responsible public servants.

Many patients may well decide that this information is irrelevant and never look at it. However, it should be available in a public, easily searchable database for those who do think it matters. Patients then have the option of identifying a doctor whose philosophies match their own. They can also help to encourage their doctor to participate in this project.

Many doctors may have qualms about their information being available in such a public forum. However, in the era of Google and social media, much of this information can already be found online, and having a voluntary disclosure gives more control to the doctor. Also, experience with other transparency pilots such as OpenNotes has demonstrated that openness leads to better communication, more trust, and better care, and it only follows that a more open relationship with our patients leads to less fear and less malpractice.

I believe that this form of radical transparency is paradigm changing. It is changing the culture of medicine from one of secrecy and mystery to one that is totally open to patients. It is a public demonstration that patient interests are primary, that reaffirms the reasons why each of us went into medicine. Every time I tell my patient about my decision to be a totally transparent doctor, every time I share my Total Transparency Manifesto, I are saying, I’m your doctor. I’m looking out for you. I’m free of influence that could affect you. Don’t be afraid of me; trust me. I’ll be vulnerable with you.

Over the last few weeks, I’ve been discussing this idea with my colleagues and my patients. So far, I have myself and 10 other doctors who are willing to be totally transparent doctors. I’d love to have doctors of all specialties to participate, to say, I’m doing what I can to restore professionalism and break down the barrier of fear.

I’d love to have you join us. What you need to commit to is to write a Total Transparency Manifesto for the website (full website TBA; see more information and my manifesto on my webpage), tell your patients about it, and share your experience with me and the readers on this blog. How did it make you feel. Scared? Uncomfortable? Defensive? Liberated? And how did your patients respond?

ADVERTISEMENT

And patients — what do you think? Please post your responses. Over the next few months, I’ll be posting my own experiences as well as the experiences of my fellow transparent doctors and our patients. Please join us in this new mission to counter fear and restore trust.

Leana Wen is an emergency physician who blogs at The Doctor is Listening. She is the co-author of When Doctors Don’t Listen: How to Prevent Misdiagnosis and Unnecessary Tests.  She can also be reached on Twitter @drleanawen.

Prev

But doctor, ultimately it is your responsibility

November 7, 2013 Kevin 18
…
Next

Physicians are the biggest driver of health costs

November 8, 2013 Kevin 30
…

Tagged as: Emergency Medicine

Post navigation

< Previous Post
But doctor, ultimately it is your responsibility
Next Post >
Physicians are the biggest driver of health costs

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Leana Wen, MD

  • a desk with keyboard and ipad with the kevinmd logo

    Help patients by addressing the health of the community

    Leana Wen, MD
  • a desk with keyboard and ipad with the kevinmd logo

    A simple act of kindness in the ER

    Leana Wen, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Learning from patients on a speaking tour

    Leana Wen, MD

More in Physician

  • The invisible weight carried by Black female physicians

    Trisza Leann Ray, DO
  • A female doctor’s day: exhaustion, sacrifice, and a single moment of joy

    Dr. Damane Zehra
  • The hidden cost of malpractice: Why doctors are losing control

    Howard Smith, MD
  • How scales of justice saved a doctor-patient relationship

    Neil Baum, MD
  • Rediscovering the soul of medicine in the quiet of a Sunday morning

    Syed Ahmad Moosa, MD
  • The broken health care system doesn’t have to break you

    Jessie Mahoney, MD
  • Most Popular

  • Past Week

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • The dreaded question: Do you have boys or girls?

      Pamela Adelstein, MD | Physician
    • The hidden cost of delaying back surgery

      Gbolahan Okubadejo, MD | Conditions
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • What happened to real care in health care?

      Christopher H. Foster, PhD, MPA | Policy
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
    • Are quotas a solution to physician shortages?

      Jacob Murphy | Education
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
  • Recent Posts

    • “Think twice, heal once”: Why medical decision-making needs a second opinion from your slower brain (and AI)

      Harvey Castro, MD, MBA | Tech
    • The invisible weight carried by Black female physicians

      Trisza Leann Ray, DO | Physician
    • A female doctor’s day: exhaustion, sacrifice, and a single moment of joy

      Dr. Damane Zehra | Physician
    • Addressing America’s reliance on psychotropic medication [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden cost of malpractice: Why doctors are losing control

      Howard Smith, MD | Physician
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician

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 58 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

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • The dreaded question: Do you have boys or girls?

      Pamela Adelstein, MD | Physician
    • The hidden cost of delaying back surgery

      Gbolahan Okubadejo, MD | Conditions
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • What happened to real care in health care?

      Christopher H. Foster, PhD, MPA | Policy
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
    • Are quotas a solution to physician shortages?

      Jacob Murphy | Education
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
  • Recent Posts

    • “Think twice, heal once”: Why medical decision-making needs a second opinion from your slower brain (and AI)

      Harvey Castro, MD, MBA | Tech
    • The invisible weight carried by Black female physicians

      Trisza Leann Ray, DO | Physician
    • A female doctor’s day: exhaustion, sacrifice, and a single moment of joy

      Dr. Damane Zehra | Physician
    • Addressing America’s reliance on psychotropic medication [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden cost of malpractice: Why doctors are losing control

      Howard Smith, MD | Physician
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician

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

Who’s my doctor? The total transparency manifesto
58 comments

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

Loading Comments...