Effects of the physician payments sunshine act on the patient experience and perception of care amongst neurosurgeons: A comparative study of online PRW ratings and industry payments

Clin Neurol Neurosurg. 2019 Jan:176:127-132. doi: 10.1016/j.clineuro.2018.12.008. Epub 2018 Dec 11.

Abstract

Objective: Growing relationships between industry related financial payments and physicians have become an increasingly controversial topic as they relate to clinical judgment and patient care. Our objective is to analyze and quantify the effects of physician reported industry payments on the patient experience and patient satisfaction as defined by Physician Rating Websites (PRW).

Patients and methods: We analyzed physician-reported industry payments received by neurosurgeons over four consecutive years as defined by the Physician Payments Sunshine Act (PPSA). All board-certified neurosurgeons on three widely used PRWs were further identified. Data was collected on average rating, number of ratings and composite ratings. Demographic, training-related and practice-related data were also collected. Each physician was identified and matched to their individually reported payments from the PPSA database.

Results: Receiving higher amounts of industrial payments had no correlation to average PRW ratings, however was associated with receiving higher composite PRW ratings (p = 0.0389). Higher composite ratings (p = 0.0389), decreasing age (p = 0.005), being male (OR 1.7960, p = 0.005), completing a fellowship (OR 1.3310, p = 0.0085), having a more complete profile (OR 1.1121, p = 0.0057) and speaking more languages (OR 1.1253, p = 0.03802) all were correlated with receiving more total monetary payments. Training at a top 25 residency program was predictive of being in the bottom quartile of total monetary payments received (OR 1.676, p = 0.0002).

Conclusions: Patient experience as defined by PRW ratings are likely not strongly influenced by industry related monetary payments, however some relationship may exist. Further study is needed to determine the true relationship between industry related monetary payments and the patient experience.

Keywords: Industry incentives; Online ratings; Patient experience; Patient satisfaction; Physician rating websites; Sunshine act.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Industry / statistics & numerical data*
  • Male
  • Middle Aged
  • Neurosurgeons / economics*
  • Neurosurgeons / education
  • Neurosurgeons / statistics & numerical data
  • Patient Satisfaction / economics*
  • Patient Satisfaction / statistics & numerical data
  • Physicians / economics*
  • Physicians / statistics & numerical data
  • Preceptorship / statistics & numerical data
  • Sex Factors
  • United States