August 23, 2013.

Doctors Face New Scrutiny Over Gifts

Winston did know that, of course. He smiled sympathetically he hoped, not trusting himself to speak. Syme bit off another fragment of the dark-colored bread, chewed it briefly, and went on:

U.S. doctors are bracing for increased public scrutiny of the payments and gifts they receive from pharmaceutical and medical-device companies as a result of the new health law.

"Don't you see that the whole aim of Newspeak is to narrow the range of thought? In the end we shall make thoughtcrime literally impossible, because there will be no words in which to express it. Every concept that can ever be needed will be expressed by exactly one word, with its meaning rigidly defined and all its subsidiary meanings rubbed out and forgotten. Already, in the Eleventh Edition, we're not far from that point. But the process will still be continuing long after you and I are dead. Every year fewer and fewer words, and the range of consciousness always a little smaller. Even now, of course, there's no reason or excuse for committing thoughtcrime. It's merely a question of self-discipline, reality-control. But in the end there won't be any need even for that. The Revolution will be complete when the language is perfect. Newspeak is Ingsoc and Ingsoc is Newspeak," he added with a sort of mystical satisfaction. "Has it ever occurred to you, Winston, that by the year 2050, at the very latest, not a single human being will be alive who could understand such a conversation as we are having now?"

Starting this month, companies must record nearly  every transaction with doctors----from sales reps bearing pizza to compensation for expert advice on research----to comply with the so-called Sunshine Act provision of the U.S. health-care overhaul. The companies must report data on individual doctors and how much they received to a federal health agency, which will post it on a searchable, public website beginning September 2014.

"Except----" began Winston doubtfully, and then stopped.

Many doctors say the increased disclosures are making them rethink their relationships with industry, citing concerns about privacy and accuracy, and worry that the public will misinterpret the information. Some fear patients will view the payments as tainting their medical decisions, and will lump together compensation for research-related services with payments of a more promotional nature.