PracticalDermatology

Beginning next month, pharmaceutical, medical device, biological, and medical supply manufacturers begin data collection under the Physician Payment Sunshine Act (“PPSA”), a consequence of The Patient Protection and Affordable Health Care Act of 2010. In March 2014, those manufacturers will report to the Department of Health and Human Services any “payment or other transfer of value” to physicians and teaching hospitals. What constitutes “value” under the rules? Anything worth more than $10.

That means many physicians still take a cup of coffee in the AAD Annual Meeting exhibit hall without signing in, right? Not necessarily. Once an entity receives $100 from a manufacturer, then all payments and gifts from that manufacturer—including that cup of coffee—must be reported. You can read about the PPSA and learn what it means for you in an informative article in the most recent edition of Modern Aesthetics (available online at http:// modernaesthetics.com/2013/06/the-five-step-protocol- to-prepare-for-the-physician-payment-sunshine-act).

The authors of that article, Michael J. Summerhill, JD and Lauren S. Berheide, JD, make an important recommenda- tion for physicians: Be prepared to discuss any reported payments with your patients. Opinions about the rule and its implications aside, the fact is that no physician can escape reporting. It is important, therefore, that dermatologists help patients understand what types of payments or “gifts” they receive from industry and why. Be prepared with an explanatory script for patients who ask about reported payments, and be sure that your staff know the right things to say to put reports in context.

There’s nothing inappropriate about receiving compensation for the time physicians spend in consulting with drug developers and marketers or educating peers. Furthermore, work- ing with industry allows physicians to contribute to patient care, generally. It is a great way to learn about therapeu- tics and new product development—a benefit to their own patients. Patients should be pleased that their physician is a trusted and respected thought leader who is called upon by industry to share expertise and insights. They should not be allowed to believe that physicians “on the pharmaceutical com- pany’s payroll” are essentially paid for writing prescriptions.

Sure, a few wiley physicians have acted inappropriately in the past by pushing bad research or entering inap- propriate quid pro quos with industry. But there are also unethical doctors out there who have no interactions with industry. Most importantly, the vast majority of physicians are ethical, upstanding altruists who put patients first. Let’s hope the Sunshine act sheds more light on that reality, rather than cast shadows on physicians who have appro- priate and acceptable industry relationships.