Patient Advocacy Reporting System (PARS)
The Patient Advocacy Reporting System (PARS), developed at the Vanderbilt Center for Patient and Professional Advocacy, is a reporting and intervention system based on unsolicited patient complaints (UPCs). Complaints reported to the PARS include those regarding care and treatment, communication, concern for patient and family, accessibility and availability, and payment issues associated with care and treatment. For each physician, a PARS Index score is calculated using a weighted algorithm emphasizing the recency and severity of UPCs.
The PARS Index score is an established predictor of a physician’s risk of future medical malpractice claims, worse patient outcomes, and well-being concerns independent of clinical volume. Physicians with greater numbers of patient complaints as reflected in a higher PARS Index score have a 3-fold increase in risk of malpractice claims.
Open Payments Program (OPP)
In 2014, the Centers for Medicare and Medicaid Services (CMS) established the Open Payments Program (OPP), a publicly available, annually updated database designed to enhance transparency regarding financial relationships between physicians, hospitals, and the pharmaceutical and medical device industries. Between 2015 and 2023, the OPP database reported a total of $72.8 billion in payments from these industries to physicians and hospitals. Of this, $22.3 billion were general payments, including nonresearch, noninvestment payments, such as consulting and speaking fees, gifts, honoraria, meals, and travel expenses. The acceptance of industry payments has the potential to influence clinical decision-making, raising a concern about financial conflicts of interests.
A study designed to examine the association between unsolicited patient complaints, measured by the Patient Advocacy Reporting System (PARS) Index, and acceptance of general (nonresearch) payments from industry, including significant payments defined as exceeding $5,000 annually, found that the 71 ,944 physicians across the United States who were included in the study “with higher PARS Index scores, indicative of a higher risk of medical malpractice claims, worse patient outcomes, and well-being concerns, were more likely to accept industry payments, particularly in higher amounts. These findings underscore the importance of conflict of interest review and management to support medical professionalism and patient trust.”
The researchers selected the $5,000 or more cutoff to reflect the current threshold set by the U.S. Department of Health and Human Services, which considers aggregated payments exceeding $5,000 a year to represent a significant financial conflict of interest.
The researchers concluded: “The observed positive association between higher PARS Index scores and the acceptance of general payments underscores potential vulnerabilities in physician professionalism. These findings emphasize the need for multifaceted strategies to address lapses in professionalism, safeguard the integrity of clinical decision-making, and strengthen patient trust. Future research should focus on evaluating the effectiveness of targeted interventions, such as peer-guided feedback to physicians who are outliers and COI review and management, to mitigate these challenges and promote a culture of accountability and transparency in health care.”
If you or a loved one may have been harmed as a result of medical malpractice in the United States, you should promptly find a medical malpractice lawyer in your state who may investigate your medical malpractice claim for you and represent you or your loved one in a medical malpractice case, if appropriate.
Click on the “Contact Us Now” tab to the right, visit our website, or call us toll-free in the United States at 800-295-3959 to find medical malpractice attorneys in your state who may assist you.
Turn to us when you don’t know where to turn.
