Should you disclose your financial incentives to patients?

Doing so may actually enhance the patient-physician relationship, according to a study in the Archives of Internal Medicine (3/27/06). The study's researchers looked at how the disclosure of the compensation system for two large physician groups-one in Boston, the other in Los Angeles-would affect patients' knowledge and trust, among other things. Patients from each group were randomly assigned to an intervention group and a control group. Those in the intervention group were sent personal and open letters about the compensation systems that were written by the chief medical officer of their physician group. All patients were surveyed about the letter about 3 months later.

The researchers found that the disclosure letters had a positive effect on patients' understanding of physicians' compensation. However, more than 50% of the nearly 8,000 patients surveyed in both cities did not feel that they knew enough about physicians' incentives to determine the possible influence on their care.

The researchers also found that the disclosure letter had no influence on the level of trust for the vast majority of patients who remembered receiving the letter (76.9% in Boston and 72% in Los Angeles). Moreover, about 22% of patients in Boston and nearly 25% of those in Los Angeles said that the disclosure actually increased their trust in their physicians. In both cities, less than 5% said that the letter decreased their trust.