Understanding the Affordable Care Act bit by bit: will transparency and sunshine shrink costs?

As of August 1, 2013, the Sunshine Act mandates that any transaction between a physician (or teaching hospital) and the pharmaceutical or device industries more than $10 in value must be publicly disclosed. Physician and industry leaders have sounded alarms about the impact of this extreme level of transparency; physicians are nervous, for they fear information published online will tarnish their reputations, and industry representatives are arguing that these financial arrangements with doctors have created "significant clinical innovations,"1 so they should not be jeopardized. Furthermore, industry representatives say disclosures may result in the unfair revelation of trade secrets.2 Despite the level of surprise expressed on both sides of this initiative, the Sunshine Act is consistent with decades of documented scrutiny as well as concern about ties between the medical and manufacturing communities. Also — as is frequently true with the ACA — most physicians are not yet aware of the details of this component of the law.