Transparency in Medicine

Dr. Leana Wen gave an important TED talk about transparency in medicine, but her campaign made other doctors angry and even generated death threats. Thankfully, however, a few hundred physicians have seen the light and joined in. Watch the video and notice the quotes.

“Being totally transparent is scary. You feel naked, exposed, and vulnerable. But … when doctors are willing to step off our pedestals, take off our white coats, and show our patients who we are and what medicine is all about, that’s when we begin to overcome the sickness of fear.” — Dr. Leana Wen

Too many doctors strongly oppose medical transparency, saying…

“I devoted 12 years of my life to being a slave. I have loans and mortgages … I depend on lunches from drug companies to serve patients.” — undisclosed

“I find it an invasion of my privacy to disclose where my income comes from. My patients don’t disclose their incomes to me.” — undisclosed

“Pretty soon we will have to disclose whether we prefer cats to dogs, what model of car we drive, and what toilet paper we use.” — undisclosed

“More government-mandated s***? Dr. Wen needs to move back to her own country.” — undisclosed

To those arguments, Dr. Wen asks those docs to tell that to their patients who make just $35K/year. She’s just interested in disclosing information that may affect the care they get, like their drug subsidies, beliefs in women’s reproductive rights, and such.

Patients Dr. Wen and her students interviewed said…

“If doctors are doing something they’re that ashamed of, they shouldn’t be doing it.” — undisclosed

“Elected officials have to disclose campaign contributions. Lawyers have to disclose conflicts of interests. Why shouldn’t doctors?” — undisclosed

“Let us patients decide what’s important when we’re choosing a doctor.” — undisclosed

But over 300 doctors have since taken the Total Transparency Pledge

“Thus has brought me closer to my patients. The type of relationship I’ve developed — that’s why I entered medicine.” — Brandon Combs, MD

“I tell my patients that I am totally open with them. I don’t hide anything from them. This is me. Now tell me about you. We’re in this together.” Aaron Stupple, MD

“My new colleagues are astounded by what I’m doing. They asked me how I could be so brave. I said, I’m not being brave. It’s my job.” Bich-May Nguyen, MD

 Transparency needs to extend Beyond Doctors

In his 38-page TIME magazine special report, “Bitter Pill: Why Medical Bills are Killing Us,” Steven Brill dove into our health care system to understand why things cost so much. What he found was both disturbing and telling. When you follow the money over decades, you see who really benefits from our sick-care system. Even more than the doctors, it’s the hospitals, insurance companies, drug companies, equipment providers, and testing companies. Meanwhile, the doctors have been squeezed and are leaving the profession and discouraging others from entering the field. And of course, the patients are also squeezed with a high-cost system that delivers relatively poor outcomes, even forcing some to buy prescription drugs illegally from Canada or travel to other countries as medical tourists.

TIME has since posted the article behind a paywall, but the link above points to my detailed summary, Brill’s video intro, and an interview with him.