Disclosures in Medicine Have the Opposite Effect?

by Chris Centeno, MD /

medical disclosure

You can’t attend a lecture or give one at a medical conference without seeing disclosure statements. The idea behind them is a good and well-meaning onethe audience needs to know if the doctor who’s lecturing takes money from a drug company or manufacturer so it can filter the advice accordingly. However, some new behavioral research shows that these disclosures actually have the opposite of the intended effect; they make the audience more likely to follow the biased advice.

Conflicts of Interest in Medicine

With the decline in physician reimbursement due to managed care, some physicians have turned toward industry to supplement their income. This type of arrangement can take many forms. For example, the doctor may lecture on behalf of a drug or device company to educate other physicians about the products that are being sold. Another common arrangement is when the doctor is paid to perform research on behalf of the company. This last one is very lucrative as once the infrastructure is developed, the physician can earn big money churning out studies.

While the universities should be the cleanest in this regard, often it’s just the opposite. Many university physicians earn less than their private-practice counterparts, so in my experience they are more likely to turn to industry to supplement their incomes. This often takes the form of research or consulting fees.

Propublica has developed a great tool to see if your doctor takes money from industry. It lets you see from whom and how much. It’s not always 100% accurate. As of this morning, I’m proud to say that my grand total is $13. In fact, since I have a policy not to let drug company reps into my office and haven’t attended a drug function in many years, it’s a mystery how I even got that much. I would suspect that it got assigned to me because some drug company rep tagged me on their report when my old physician’s assistant attended a lunch.

The Psychology of Disclosures

The whole purpose of letting an audience know that you took money from company X to do Y is that the audience will then filter your advice accordingly. However, does that really work? Based on some recent research, not really. For example, in one study, disclosure by a trusted authority actually increased the audience’s burden to comply with that advicehaving the direct opposite effect.

This problem for disclosure also extends to things like specialty bias. For example, it’s well known that surgeons often suggest surgery more commonly than nonsurgeons. However, in another recent study, when surgeons disclose this bias, it doesn’t make the patient less likely to end up in surgery or the surgeon less likely to recommend surgeryit has the opposite effect. The patient is more likely to choose surgery, and the physician is more likely to perform surgery!

Are There Solutions?

The author of the two papers cited above has some recommendations based on his research:

  1. The disclosure is provided by an external source rather than from the advisor.
  2. The advisee has an opportunity to change his/her mind later.
  3. The advisee is able to make the decision in private.

The upshot? These days in medicine, a good number of doctors take money from industry. It looks like the disclosure systems designed to help physicians and patients make informed healthcare decisions are having the opposite of the intended effect. Does this mean we should scrap the whole system? Not sure. However, the next time someone discloses something, you may want to walk away and think about it before you make a reflex decision to go with the advice anyway!

Category: Latest News

Leave a Reply

Your email address will not be published. Required fields are marked *

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
View Profile

Get Blog Updates by Email

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Providers Near Ashburn, VA

Regenerative procedures are commonly used to treat musculoskelatal trauma, overuse injuries, and degenerative issues, including failed surgeries.
Select Your Problem Area
Shoulder

Shoulder

Many Shoulder and Rotator Cuff injuries are good candidates for regenerative treatments. Before considering shoulder arthroscopy or shoulder replacement, consider an evaluation of your condition with a regenerative treatment specialist.

  • Rotator Cuff Tears and Tendinitis
  • Shoulder Instability
  • SLAP Tear / Labral Tears
  • Shoulder Arthritis
  • Other Degenerative Conditions & Overuse Injuries
Learn More
Cervical Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Knee

Knees

Knees are the target of many common sports injuries. Sadly, they are also the target of a number of surgeries that research has frequently shown to be ineffective or minimally effective. Knee arthritis can also be a common cause for aging athletes to abandon the sports and activities they love. Regenerative procedures can be used to treat a wide range of knee injuries and conditions. They can even be used to reduce pain and delay knee replacement for more severe arthritis.

  • Knee Meniscus Tears
  • Knee ACL Tears
  • Knee Instability
  • Knee Osteoarthritis
  • Other Knee Ligaments / Tendons & Overuse Injuries
  • And more
Learn More
Lower Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Hand & Wrist

Hand & Wrist

Hand and wrist injuries and arthritis, carpal tunnel syndrome, and conditions relating to overuse of the thumb, are good candidates for regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Hand and Wrist Arthritis
  • Carpal Tunnel Syndrome
  • Trigger Finger
  • Thumb Arthritis (Basal Joint, CMC, Gamer’s Thumb, Texting Thumb)
  • Other conditions that cause pain
Learn More
Elbow

Elbow

Most injuries of the elbow’s tendons and ligaments, as well as arthritis, can be treated non-surgically with regenerative procedures.

  • Golfer’s elbow & Tennis elbow
  • Arthritis
  • Ulnar collateral ligament wear (common in baseball pitchers)
  • And more
Learn More
Hip

Hip

Hip injuries and degenerative conditions become more common with age. Do to the nature of the joint, it’s not quite as easy to injure as a knee, but it can take a beating and pain often develops over time. Whether a hip condition is acute or degenerative, regenerative procedures can help reduce pain and may help heal injured tissue, without the complications of invasive surgical hip procedures.

  • Labral Tear
  • Hip Arthritis
  • Hip Bursitis
  • Hip Sprain, Tendonitis or Inflammation
  • Hip Instability
Learn More
Foot & Ankle

Foot & Ankle

Foot and ankle injuries are common in athletes. These injuries can often benefit from non-surgical regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Ankle Arthritis
  • Plantar fasciitis
  • Ligament sprains or tears
  • Other conditions that cause pain
Learn More

Is Regenexx Right For You?

Request a free Regenexx Info Packet

REGENEXX WEBINARS

Learn about the #1 Stem Cell & Platelet Procedures for treating arthritis, common joint injuries & spine pain.

Join a Webinar

RECEIVE BLOG ARTICLES BY EMAIL

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Subscribe to the Blog

FOLLOW US

Copyright © Regenexx 2019. All rights reserved. | Privacy Policy

*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.

Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.