Physicians with more patient complaints also more likely to receive industry payments

Johns Hopkins University School of Medicine and Vanderbilt University Medical Center investigators report that physicians who attract more unsolicited patient complaints also tend to accept larger nonresearch payments from industry.

Patient welfare is the foundation of medical professionalism. Unprofessional behavior can put patients at risk and increase malpractice risk. Industry payments to physicians may influence clinical decisions, creating potential professional conflicts.

Tools such as the Patient Advocacy Reporting System quantify unsolicited patient complaints linked to adverse outcomes. Separately, the Open Payments Program tracks financial entanglements between physicians and industry. But how do these two forms of risk overlap?

In the study, “Unsolicited Patient Complaints and Industry Payments for US Physicians,” published in JAMA Network Open, researchers conducted a retrospective cross-sectional study to examine the association between unsolicited patient complaints, measured by the Patient Advocacy Reporting System Index, and acceptance of general industry payments, categorized annually as $0, $1 to $4,999, or $5,000 or more.

Data covered 71,944 physicians practicing at Patient Advocacy Reporting System-participating sites nationwide from 2015 to 2020.

Investigators linked each physician’s highest PARS Index score to Open Payments Program disclosures using National Provider Identifier numbers and categorized general payments into $0, $1-$4,999, or ≥$5,000 annually.

Results showed that 68.3% of physicians accepted at least one general payment, and 11.2% collected more than $5,000 in a single year. Physicians in higher complaint categories were increasingly likely to receive larger payments, with those in the highest PARS Index tier (≥51) showing an adjusted odds ratio of 1.69 compared with those with a score of 0.

Male physicians were more likely to receive higher general payments regardless of complaint history with an OR of 1.90. Nonacademic practice was also associated with higher payment likelihood (OR, 1.15).

The authors conclude that vigilant conflict-of-interest review, coupled with peer feedback interventions for high-complaint physicians, can bolster professionalism and maintain patient trust.

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