Journal of Medicine - The Obama administration is poised to enact regulations requiring that the manufacturers of drugs, medical devices and medical supplies disclose all payments they make to doctors or teaching hospitals. The information, which would be posted on a government Web site, will allow patients to see any "conflicts of interest".

Such payments can be for legitimate research and consulting. But there is also a lot of cash being spread around to pay for doctors’ travel and entertainment or for gifts or modest meals for a prescribing doctor’s staff.

Some prominent doctors and researchers receive hundreds of thousands or even millions of dollars a year in exchange for providing advice to a company or giving lectures on its behalf. About a quarter of all doctors take some cash payments from drug or device makers and nearly two-thirds accept meals or food gifts. Analysts contend that even seemingly trivial gifts can influence doctors to prescribe expensive drugs that may not be best for a patient’s health or pocketbook.

The new rules were championed by Senator Charles Grassley, a Republican, and Senator Herb Kohl, a Democrat, and incorporated into the health care reforms enacted in 2010. The reform law required the Department of Health and Human Services to establish reporting procedures by Oct. 1, 2011, and required manufacturers to start collecting the relevant data starting Jan. 1, 2012.

The Centers for Medicare and Medicaid Services will publish the disclosure data on a public Web site that the law says must be searchable and understandable so that patients and advocacy groups can see which doctors are being paid and how much. Manufacturers could be fined up to $150,000 a year for failing to report payments and up to $1 million a year for “knowingly” failing to report.

The new rules should will affect all companies, medical centers, scientific journals, states and ethical codes to with the intention to eliminate, minimize and disclose financial interests that might "cloud" medical judgments. The existence of the Web site could deter some questionable payments. And it may affect how patients decide which doctors to rely on.



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