Alexander C. Tsai, MD, PhD
Potential Financial Conflicts of Interest: Dr. Tsai is a member of the ethics committee for the National Physicians Alliance, an organization that supports a legislative ban on the sale of physician prescribing data for commercial and marketing purposes.
Tsai AC. Prescriber Profiling. Ann Intern Med. 2008;148:81. doi: 10.7326/0003-4819-148-1-200801010-00012
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Published: Ann Intern Med. 2008;148(1):81.
TO THE EDITOR:
Given that fewer than 1% of American Medical Association (AMA) members have participated in the Prescribing Data Restriction Program (PDRP), only 25% of surveyed members are aware of the program's existence, and 66% disapprove of the sale of physician-specific prescribing data to drug companies, Grande's concern that “the AMA opt-out program is not an effective way to address the concerns of physicians and their patients” (1) is a tactful understatement.
A thorough literature review at the PDRP's inception would have revealed that opt-out programs are designed to maximize participation while preserving a patina of choice. Implementation of opt-out mechanisms in various contexts has increased participation in prenatal HIV testing (2), medical journal reviewing (3), clinical research studies (4), and 401(k) plan saving (5). Clearly, default options have an enormous effect on decisions. Implicit in any decision to implement an opt-out policy is a value judgment that the default choice option is socially preferable (5).
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