FAQWhy is this project important?
We believe that patients should know who their doctors are. The most basic level is where their doctors get their money: are they getting paid by drug companies and medical device companies? Are they getting paid more to do more tests or procedures? All of these factors may influence patient care, and patients have a right to know. Another level is in choosing your doctor. Having information available about doctors’ philosophies and personal views allows patients maximal choice in selecting a doctor whose views align with their own.
Will doctors join?
There are many doctors who are very concerned about the conflicts of interest in our profession and want to make a difference by restoring professionalism. Who’s My Doctor gives them an opportunity to do so. Our hope is that these initial doctors who sign up will spread the word, with help from our patients, and recruit all doctors to be open about who we are.
What have patients and patient groups said about Who’s My Doctor?
Patient groups are generally in favor of having access to more information about healthcare choices. You can see a partial list of endorsements here.
Why aren’t there more doctors on this site?
Who’s My Doctor started in October 2013. We are actively recruiting doctors to participate; many who are not yet on the site have signed up but have not yet submitted their Total Transparency Manifestos. If you are a doctor and interested in participating, please contact us. The word can only spread with active participation from patients, so if you are a patient, we need your help too.
What is your hope for this project?
Our hope is that all doctors will participate in publicly declaring who they are, disclosing potential conflicts of interests and letting patients know about us so that our patients—the people we serve—can have better options to make healthcare decisions.
Isn’t this intrusive for doctors? Won’t this result in loss of privacy?
Participation is voluntary, and doctors can choose what information they would like to disclose. Some doctors wish to only disclose potential conflicts of interest; others wish to have more personal information including their philosophy of practice of preventive care, women’s healthcare, end of life choices, etc, available for their patients to see.
How is all this information relevant?
We don’t presume that all information is relevant to every patient. Some patients may not wish to know their doctor’s revenue streams; others may not want to know their doctors’ personal information. However, some patients will want to know this information when making a decision about which doctor to choose. Rather than having doctors deciding what information is important, we prefer to give that choice to patients.
Why do you have ask such personal questions of doctors as their views on issues and their religion and politics?
Research shows that patients are more likely to comply with recommendations when they come from a doctor whose world view aligns more closely with their own. Who’s My Doctor offers the opportunity to find doctors who have particular expertise and interest in certain fields, such as preventive health, alternative medicine, women’s health, etc. This information is voluntary, so doctors don’t have to discuss their personal views on these issues. Some doctors choose to disclose personal stories and views, because we believe it humanizes us, and that sharing the stories allow patients insight into who we are and how we think.
What if patients don’t want to know about their doctors’ views and affiliations?
This site is voluntary for patients, too, so they don’t have to search their doctor if they choose not to know.
How is Who’s My Doctor funded?
Who’s My Doctor is entirely non-profit. All information is publicly accessible and the intention is to not profit from doctors or patients. At the moment, I (Dr. Wen) volunteer my time and recruit other doctors to assist who also volunteer their time and effort. We are seeking donations from foundations and individuals who would like to make a difference in restoring trust to medicine; please contact us for further information.
What about other health professions? Or international doctors?
We are looking into expanding this site to include other health professionals, including Nurse Practitioners, Physician Assistants, Dentists, Optometrists, etc. We would also love to work with health professionals in other countries to spearhead initiatives there. Please contact us.
How can I explain to my patients about my affiliations with drug/device companies? Won’t it make my patients trust me less?
Our advice is to be entirely explicit about the nature of these affiliations. Are you part of a multi-center clinical trial, or are you getting paid as a consultant and speaker? How much revenue are you getting? Why are you taking part in these affiliations? If your intention is truly to advance science and medicine, your patients will understand; if it is not, perhaps the fear of disclosure is an indication that you should reconsider these engagements.
I have to practice fee-for-service medicine because that’s the group practice model that I belong to. How do I explain this to patients?
Exactly as you have above. Perhaps you are limited by geography and this is the only group you can join. Perhaps this is the limitation imposed upon you by the healthcare system. We argue that it’s important for patients to know how we are paid, and need to trust that our patients will understand if we explain.
How can I explain to my colleagues about my revenue sources?
If your revenue sources are a source of contention for your colleagues, it might be worth considering why. Remember that it is standard practice in many other professions to disclose conflicts of interest, and hesitation in disclosure could be a sign that what you are doing may not be worth continuing.
What if patients don’t come to me because of my views?
If patients don’t come to you because you have significant conflicts of interest, perhaps it is worth considering these potential conflicts. If they don’t come to you because of your views, perhaps this should not be seen as a negative, because it’s important for patients to find a doctor they trust. It should be up to patients to decide what factors are important for them, and if they choose not to come to you, that is their choice. The U.S. is facing a significant shortage of doctors, so it is patients who have the greater burden to find a doctor than it is for doctors to find patients.
How do you verify that the information on this site is accurate?
Everything on this site is self-report from doctors. We do not independently verify that the information is correct. Participating doctors understand that they are solely responsible for the accuracy of the information, and that any false information will be perceived to be far worse than an accurate disclosures. That said, we cannot ensure accuracy of information, so if you see a discrepancy, please contact the individual doctor or contact us.
Aren’t there other websites with similar information?
Propublica has a Dollars for Docs website where you can look to see whether your doctor receives money from drug companies, and the Accountable Care Act has a provision (Physician Sunshine Act) where a website is to be launched in September 2014 with the same information. However, this does not allow doctors to explain the source of the funding, and there is a difference in whether the doctor receives money to participate in a multi-center clinical trial versus a speaking engagement. Who’s My Doctor allows for this explanation. In addition, there are some private practices that market their doctors with personal information such as training location; however, this is not standardized, and is usually not integrated with conflicts of interest information. Who’s My Doctor aims to be a searchable national database of both types of information.
What are reasons doctors state for not belonging to Who’s My Doctor?
There are three main reasons doctors state for not belonging. First, they say that they don’t want information about them out there in public domain. Our response is that in the era of Google and social media, much of the information is already found online, and having a voluntary disclosure gives more control to the doctor to write what they want about their philosophy of practice. Second, they will say it’s not the patients’ business what their revenue sources are. We argue that it absolutely is. Doctors already disclose our revenue sources at scientific conferences because ample studies show that such conflicts have real influences on us. If we tell each other about our conflicts, why not tell our patients—the people we serve? Third, they talk about loss of privacy and the need to maintain professional distance. We will remind doctors that this is a relatively new phenomenon. Just a generation before, doctors and patients knew each other intimately. They grew up in the same town, and patients knew exactly who their doctors were, where they went to church, what their families are like, etc. This fostered trust and understanding. Not every patient wants such a relationship and not every doctor does, but Who’s My Doctor allows for patients to choose their doctor who does want a similarly close relationship.
Will Who’s My Doctor have a positive impact on patient care and clinical outcomes?
It is far too early to tell. However, we expect that it will. Studies show that patients are more likely to follow recommendations and to have better outcomes when the advice comes from a doctor they trust. Experience with other transparency pilots such as Open Notes shows that openness leads to better communication, more trust, and better care, and we predict that Who’s My Doctor will have similar outcomes. That said, we recognize that medicine is a conservative profession, and change is hard; that’s why we need your help to restore trust and improve medical care.