Skip to content
  • About
  • Contact
  • Contribute
  • What Physicians Say
  • My Book
  • Careers
  • Podcast
  • Speaking
KevinMD.com — Social media's leading physician voice
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • What Physicians Say
    • My Book
    • Careers
    • Podcast
    • Speaking
KevinMD.com — Social media's leading physician voice
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • What Physicians Say
    • My Book
    • Careers
    • Podcast
    • Speaking
  • About Kevin Pho, MD, Founder of KevinMD
  • Aging and dementia: what physicians say, in their own words
  • Artificial intelligence: what physicians say, in their own words
  • Be heard on social media’s leading physician voice
  • Cancer: what physicians say, in their own words
  • Children’s health: what pediatricians say, in their own words
  • Contact Kevin
  • COVID-19: what physicians wrote as it happened
  • Custom enhanced author page pricing
  • Diabetes and obesity: what physicians say, in their own words
  • Direct primary care: what physicians say, in their own words
  • DMCA Policy
  • End of life: what physicians say, in their own words
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • GLP-1 drugs: what physicians say about Ozempic and its successors, in their own words
  • Heart disease: what physicians say, in their own words
  • Immigration and medicine: what physicians say about immigrant doctors and immigrant patients, in their own words
  • KevinMD influencer opportunities
  • Medical errors: what physicians say, in their own words
  • Medical ethics: what physicians say, in their own words
  • Medical malpractice: what physicians say, in their own words
  • Medical school: what students and physicians say, in their own words
  • Mental health: what psychiatrists and physicians say, in their own words
  • Nursing: what nurses and physicians say, in their own words
  • Opinion and commentary by KevinMD
  • Opioids: what physicians and pain patients say, in their own words
  • Physician burnout speakers to keynote your conference
  • Physician burnout: what physicians say, in their own words
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician personal finance: what physicians say about their own money, in their own words
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Physician suicide: what physicians say, in their own words
  • Physicians and administrators: what physicians say about who runs medicine, in their own words
  • Primary care physician in Nashua, NH | Kevin Pho, MD
  • Primary care: what physicians say, in their own words
  • Prior authorization: what physicians say, in their own words
  • Privacy Policy
  • Private equity and corporate medicine: what physicians say, in their own words
  • Race and medicine: what physicians say, in their own words
  • Recommended services by KevinMD
  • Residency: what residents and attendings say, in their own words
  • Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words
  • Subscribe to the KevinMD enhanced author page
  • Subscribe to the newsletter
  • Surgeons and surgery: what surgeons say, in their own words
  • Take-home messages: what physicians say when asked to leave one
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The electronic health record: what physicians say, in their own words
  • Vaccines: what physicians say, in their own words
  • Violence against health care workers: what physicians and nurses say, in their own words
  • What physicians say: the KevinMD records
  • Women in medicine: what women physicians say, in their own words
  • Women’s health: what physicians say, in their own words

The Sunshine Act escalates the war on physicians

Arvind Cavale, MD
Health Policy
October 23, 2014
Share
Tweet
Share

shutterstock_95385217

The media has feasted on the recent release of data by the Center for Medicare and Medicaid Services (CMS) that details payments made by the pharmaceutical and device companies to hospitals and physicians in 2013. This was part of the the Physician Payments Sunshine Act (PPSA) — also known as section 6002 of the Affordable Care Act (ACA) of 2010.

What the media refuses to write is that these payments were made for specific legitimate services provided by these doctors and hospitals. The premise in all these media reports is that these payments were somehow inappropriate and influenced prescribing or practice patterns of those physicians and hospitals.

Even a prestigious newspaper such as the Wall Street Journal jumps on this anti-doctor bandwagon with a story titled “Doctors Net Billions From Drug Firms” when the actual article reveals the majority of payments going to hospitals, not doctors. But who cares about details? Either the Journal does not understand the difference between doctors and hospitals, or it intends to purposely distort the message. The exact intent is unclear to me!

Even the journal Health Affairs in its paper titled “The Physician Payments Sunshine Act” casually states “they [financial relationships] can also create conflicts of interest and in some cases can blur the line between promotional activities and the conduct of medical research, training, and practice.” This paper does not provide a single reference to support this statement, and the paper is published as if it was a matter of fact. But who cares about evidence?

My own research on this matter of conflict of interest lead me to this page which lists some investigations on this issue, the latest of which is from 2005. So far, I have yet to unearth any objective data that show even a hint of conflict.

Ed Silverman, in his blog Pharmalot, asks this question: Does the Open Payments Database ‘Distort’ What Docs Get For Research? Here researchers from Johns Hopkins point out how such disclosures can hurt physician participation in clinical research and why these payments can easily distort the picture. Again, who cares about consequences?

After nearly 20 years of clinical practice, I have yet to encounter even one instance where I felt I prescribed a drug or referred a patient for a test under the influence of a payment or gift from a pharmaceutical company. Every physician I know of feels the same way. Our loyalty is and should be to our patient only and patient benefit should be our criteria while prescribing a drug or device.

I find it interesting that the government is going to great lengths to “expose” potential financial conflicts of interest via the Sunshine Act, while at the same time creating the accountable care organizations which are designed to make doctors and hospitals choose or deny certain therapies in order to make more money without any patient knowledge that their care is under an ACO.  The Affordable Care Act’s creation of accountable care organizations and value-based care models, hurts both patients and doctors and, either by accident or design, destabilizes trust in our relationship.

The Sunshine Act adds one more suggestion that patients should distrust their doctors. I am not surprised that leaders of both political parties gang up against physicians, but I am astonished that the major media outlets have bought into this notion, without asking for evidence of conflict. Could it be possible that these actions are a concerted effort by those in power to force patients to accept government-prescribed cook-book medical care as the only option available to them, by forcing physicians to be mere pawns in this chess game? Someone tell me it ain’t so!

We physicians need the trust of our patients in this difficult hour. I am confident that the sacred patient-physician relationship will prevail over all this noise being created by the media, in collaboration with our political leaders. It is time we remind our dear leaders and media moguls to think twice before trying to destabilize the patient-physician relationship, just for their own personal gains.

Arvind Cavale is an endocrinologist who blogs at Rebel.MD. He can be reached on Twitter @endodocPA.

Image credit: Shutterstock.com

Prev

A case that illustrates the good, the bad and the ugly of American medicine

October 23, 2014 Kevin 17
…
Next

Which is the right flu vaccine for you?

October 23, 2014 Kevin 0
…

ADVERTISEMENT

Tagged as: Medications and Prescribing

< Previous Post
A case that illustrates the good, the bad and the ugly of American medicine
Next Post >
Which is the right flu vaccine for you?

 

ADVERTISEMENT

More by Arvind Cavale, MD

  • Political leaders are oblivious to the true causes of physician burnout

    Arvind Cavale, MD
  • Improve Medicaid with these simple steps

    Arvind Cavale, MD
  • Caring and dedicated physicians are being driven out of medicine

    Arvind Cavale, MD

Related Posts

  • Are patients using social media to attack physicians?

    David R. Stukus, MD
  • The risk physicians take when going on social media

    Anonymous
  • Beware of pseudoscience: The desperate need for physicians on social media

    Valerie A. Jones, MD
  • When physicians are cyberbullied: an interview with ZDoggMD

    Monique Tello, MD
  • Surprising and unlikely rewards of social media engagement by physicians

    Lisa Chan, MD
  • Physicians who don’t play the social media game may be left behind

    Xrayvsn, MD
  • Join the KevinMD Facebook group for physicians

    Kevin Pho, MD
  • American physicians deserve timely payment

    Peter Ubel, MD
  • The war on drugs: America’s secret racist war today

    Jay Wong
  • Physicians and medical students: Unlearn helplessness

    Jamie Katuna
  • Essential health messaging tips for physicians [PODCAST]

    The Podcast by KevinMD
  • Physicians are trapped between patient satisfaction and unnecessary prescribing

    Richard Young, MD

More in Health Policy

  • The next child

    Medicaid managed care and the case for mutual stewardship

    Steven Merahn, MD
  • How to build a dementia care pathway, not a referral sheet

    Gerald Kuo
  • AI in prior authorization: 3 contract questions for 2027

    Matt Hasan, PhD
  • Private equity in medicine did not kill private practice

    Brian Hudes, MD
  • Why are fewer family physicians delivering babies?

    Frista Gradica
  • Local news and public health: the segment viewers missed

    Ronald L. Lindsay, MD
  • Most Popular

  • Past Week

    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • The conflict of interest that discloses as nothing

      Martha Rosenberg | Medications
    • Surgical judgment: the skill no one sees from the gallery

      Mustafa Kemal Çalık, MD | Physician
    • Why haven’t ambient AI scribes boosted productivity?

      Karan Kanwar | Health Technology
    • 3 reforms to counter wellness influencers in practice

      Farid Sabet-Sharghi, MD | Physician
    • Physician well-being is not an individual problem

      Heather Buckley | Conditions and Diseases
  • Past 6 Months

    • Why CDC opioid guidelines get the overdose data wrong

      Richard A. Lawhern, PhD | Conditions and Diseases
    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • Sensory processing in autism and the brain’s volume control

      Josette Pelatan, PhD | Conditions and Diseases
    • What maternity care deserts cost a town

      Manisha Kaliaperumal | Health Policy
    • Why medicine needs a national physician license now

      Vaishali Popat, MD, MPH | Physician
    • A cold cost $945. The cost of primary care is broken.

      Susan Newman, MD | Physician
  • Recent Posts

    • 3 reforms to counter wellness influencers in practice

      Farid Sabet-Sharghi, MD | Physician
    • Shift work and circadian rhythms shape the 24/7 workplace

      Deepak Gupta, MD | Conditions and Diseases
    • Paid for twice

      Physicians paid for G2211 twice. Most never bill it.

      Michael Duben, MD | Physician Finance
    • The next child

      Medicaid managed care and the case for mutual stewardship

      Steven Merahn, MD | Health Policy
    • Choosing a limb lengthening surgeon requires accountability

      Hrayr Basmajian, MD | Physician
    • Cited but never checked

      Why AI crisis advice may fail families facing psychosis

      Nicole Drapeau Gillen | Health Technology

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 50 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

  • Most Popular

  • Past Week

    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • The conflict of interest that discloses as nothing

      Martha Rosenberg | Medications
    • Surgical judgment: the skill no one sees from the gallery

      Mustafa Kemal Çalık, MD | Physician
    • Why haven’t ambient AI scribes boosted productivity?

      Karan Kanwar | Health Technology
    • 3 reforms to counter wellness influencers in practice

      Farid Sabet-Sharghi, MD | Physician
    • Physician well-being is not an individual problem

      Heather Buckley | Conditions and Diseases
  • Past 6 Months

    • Why CDC opioid guidelines get the overdose data wrong

      Richard A. Lawhern, PhD | Conditions and Diseases
    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • Sensory processing in autism and the brain’s volume control

      Josette Pelatan, PhD | Conditions and Diseases
    • What maternity care deserts cost a town

      Manisha Kaliaperumal | Health Policy
    • Why medicine needs a national physician license now

      Vaishali Popat, MD, MPH | Physician
    • A cold cost $945. The cost of primary care is broken.

      Susan Newman, MD | Physician
  • Recent Posts

    • 3 reforms to counter wellness influencers in practice

      Farid Sabet-Sharghi, MD | Physician
    • Shift work and circadian rhythms shape the 24/7 workplace

      Deepak Gupta, MD | Conditions and Diseases
    • Paid for twice

      Physicians paid for G2211 twice. Most never bill it.

      Michael Duben, MD | Physician Finance
    • The next child

      Medicaid managed care and the case for mutual stewardship

      Steven Merahn, MD | Health Policy
    • Choosing a limb lengthening surgeon requires accountability

      Hrayr Basmajian, MD | Physician
    • Cited but never checked

      Why AI crisis advice may fail families facing psychosis

      Nicole Drapeau Gillen | Health Technology

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use Agreement
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The Sunshine Act escalates the war on physicians
50 comments

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

Loading Comments...