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Payments to Physicians: Does the Amount of Money Make a Difference?

The federal Open Payments database makes public the amount and type of payments from drug and device companies to individual physicians.1 It seems plausible that very large payments warrant greater concern about conflict of interest causing bias and undue influence. The degree of concern will vary, however, according to the type of financial relationship and the nature of the physician’s advice or activity. In several situations, the existence of bias can be investigated directly, or the financial relationship effectively and simply managed.