Disclosure of physicians' financial incentives may increase trust, loyalty among their patients

survey that included questions about health status and demographics, knowledge of the model by which their physicians were paid, and patients' trust and loyalty in their physicians.

In Boston, 1,138 of the 2,352 patients who had received a disclosure statement and 1,277 of the 2,398 patients who did not receive a statement responded to the survey; in Los Angeles, responses were received from 533 of 1,449 patients who had received disclosure statements and from 549 of 1,421 who had not. In both cities, patients who had received a disclosure were more likely to correctly identify the model by which their physicians were paid--45.1 percent vs. 27.1 percent in Boston and 37 percent vs. 23.6 percent in Los Angeles. These rates were even higher among patients who were mailed a disclosure and remembered receiving it (56.9 percent in Boston and 48.4 percent in Los Angeles). Patients who received a disclosure were also more likely to report that they knew enough about their physician's payment model to judge its possible influence on their health care (32.5 percent vs. 17.8 percent in Boston, 31.8 percent vs. 26.4 percent in Los Angeles).

Overall, patients receiving a disclosure did not experience a significant change in levels of trust in their physicians. But among patients who remembered receiving a disclosure, 21.4 percent in Boston and 24.4 percent in Los Angeles responded that it had increased their trust either greatly or somewhat, less than 5 percent of patients in either city reported that it decreased their trust somewhat, and none said that it decreased their trust greatly. Loyalty to the physician group, measured by asking patients whether they would be unlikely to switch medical groups in the next couple of years, was higher among patients who received a disclosure and was significantly higher in the disclosure group in Boston (73.4 percent vs. 70.2 percent).

Based on the findings in the study, it appears likely that many patients

Contact: Leah Gourley
JAMA and Archives Journals

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