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The Danger of Information without Context

January 24, 2012
3:40 pm

If you’ve ever watched the movie “The Sixth Sense,” you see what a talented director and writer can accomplish by withholding critical information from the audience.  In that movie (and, no, I’m not going to spoil it if you haven’t seen it), M. Night Shyamalan holds back an essential fact about Bruce Willis’s main character until the very end of the film.  When that fact is revealed, it changes the entire context of what we thought we knew about the story.

What works well, though, in the cinema isn’t necessarily a sound methodology when it comes to public policy matters that affect lives.  Transparency is public matters is virtually always a good thing, but when the practice of transparency reveals facts without context, it can be counterproductive.

Dr. Thomas Stossel, a professor of medicine at Harvard Medical School, discussed this issue in a Wall Street Journal op-ed this week, “Who Paid For Your Doctor’s Bagel?” In his op-ed piece, he discusses the Physicians Payment Sunshine Act, a new law that will require medical innovation companies to disclose any transfer of value to physicians.  The Centers for Medicare and Medicaid Services (CMS) has recently issued draft guidelines for implementation of the new law.

Again, in principle, this type of transparency is a good thing.   But when the new law results in a list of consulting fees and other payments made by pharmaceutical and medical device companies to physicians, there will be a piece of the puzzle still missing.  What is the purpose of that exchange beyond a minimalist bureaucratic definition such as “consulting fee?”  What was the impact for patients and for the current and future practice of healthcare?  Without this context, negative inferences can be made about any exchange of value.

As Stossel wrote in the Journal, “The media already exploit disclosures….to demean physicians compensated by royalties from useful inventions that they license to companies, or who were paid consulting fees for advice concerning the optimal use of products, or for educating other physicians about products.”

The fact is that collaborations between physicians and industry have led to some of the most important medical breakthroughs of the last several decades.  Physicians help guide industry on how to make new innovations beneficial for patients.  Companies train physicians on the optimal use of new drugs and devices.  This sharing of knowledge is essential to the advancement of healthcare.

We’ll be discussing this issue in greater detail in the months ahead.  HLC launched an initiative called the National Dialogue for Healthcare Innovation and, through this effort, multiple organization representing healthcare providers, health industry sectors, academia and patients have been developing a consensus set of principles to help guide future physician-industry collaborations.  More to come.

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