Indiana University

IU Kelley School experts on Open Payments: Patients do not view all financial relationships equally

  • Oct. 2, 2014


BLOOMINGTON, Ind. -- On Tuesday, the federal government released data from its Open Payments website about payments made to doctors and teaching hospitals by pharmaceutical and medical device companies, as mandated by the Affordable Care Act.

The Centers for Medicare and Medicaid Services, which compiled the records into a database, reported that companies paid close to $3.5 billion in the last five months of 2013. It also revealed that about 40 percent of the payment information doesn't identify recipients because of data issues.

In a new paper, three professors at Indiana University's Kelley School of Business question whether greater transparency might influence patients’ trust in physicians; patients’ perceptions of their physician’s expertise; and ultimately, how a patient’s selecting a physician might be affected by the Open Payments system.

“According to our findings, patients do not view all financial relationships equally; rather, from the patient’s perspective, it matters what the doctor is being paid for,” said Joshua Perry, assistant professor of business law and ethics and a Life Sciences Research Fellow, one of three authors of an upcoming paper in the Journal of Law, Medicine & Ethics.

Perry and co-authors Dena S. Cox, professor of marketing and Schmenner Faculty Fellow in the Kelley School and an adjunct professor of pediatrics in the IU School of Medicine; and Anthony D. Cox, chair of the Business of Medicine MBA Program at Kelley-Indianapolis, professor of marketing and Hatfield Faculty Fellow, surveyed 881 health care consumers about specific types of routine payments made by drug and device companies to health care providers.

They wanted to know how greater transparency might influence patients’ trust in their physicians, as well as patients’ perceptions of their physician’s expertise and how patient decision-making with regard to selection of a physician might be affected. They wondered whether people would consult the Open Payments database and use information about potential conflicts of interest and then shop around.

Key findings included:

  • How payments were characterized was more important and influential in the minds of patients than the amounts that were reported. Respondents indicated that physicians who were paid for consulting with industry -- regardless of how much -- would be viewed as “experts in the field” and “better informed about the latest treatments.” This view was in stark contrast to scenarios where physicians were paid for purposes of travel, which resulted in a decrease both in terms of perceived expertise and perceived trustworthiness.
  • Greater amounts of money paid for purposes of travel resulted in a greater negative impact upon the physician’s perceived moral character.
  • Likewise, physician ownership of stock or an investment interest was found to decrease the patients’ level of trust in their physician’s judgment, with a correlating negative impact based on the amount of stock ownership.
  • Specifying the types of financial relationships between physicians and industry is critical to whether patients perceive the relationship positively or negatively, whether trust in one’s physician is bolstered or undermined.
  • Assuming a good-faith justification is present, it appears that patients are likely to interpret many of these financial relationships in a positive light.
  • Their study also suggested that data collected for the Open Payments website may need to be made available in more places and not only online.

The article, “Trust and Transparency: Patient Perceptions of Physicians’ Financial Relationships with Pharmaceutical Companies,” will be published in December. It is available to reporters on request.

Related Links

Media Contacts

George Vlahakis

Joshua Perry

Michael Jackson

Assistant Director, Communications and Media (Indianapolis)