Are payments from drug companies to doctors legal?

Yes. Payments for consulting, research, speaking, royalties and meals are legal. The Sunshine Act requires them to be reported, not stopped.

Can doctors refuse to be listed in Open Payments?

No. Companies are legally required to report the payments. Doctors can review and dispute records that are inaccurate, but they cannot opt out of the federal record.

Should I change doctors if mine receives industry payments?

Not on that basis alone. A payment is not evidence of poor care. If it concerns you, ask your doctor how they choose treatments, or get a second opinion on a major decision.

Does a payment from a drug company mean a doctor did something wrong?

What CMS says

The agency that runs Open Payments is direct about it: “Just because financial ties are reported in Open Payments does not mean anyone has done anything wrong.” CMS publishes the relationships so they can be seen; it “does not comment on what relationships may be beneficial or potential conflicts of interest.” Doctors do not choose to be listed — companies are required by law to report them.

Why companies pay doctors at all

Research. New drugs and devices are tested in clinical trials run by doctors and hospitals, and the manufacturer pays for that work.
Expertise. Companies hire doctors to advise on how a product is designed, used and made safer.
Education. Doctors are paid to teach other clinicians how to use a treatment or device.
Royalties. A doctor who invented or helped design a product can earn a royalty on it.
Meals and travel. Often the cost of attending a meeting or a sales presentation.

All of these are legal and, in medicine, common.

What the record can and cannot tell you

Published studies have found that, on average, doctors who receive payments related to a drug — even small ones such as meals — tend to prescribe that drug somewhat more often. That is a pattern across thousands of doctors. It does not show that any particular doctor changed a decision because of a payment, and a listing on its own says nothing about the quality of the care someone gives.

What the record can tell you is:

which companies reported paying a doctor, and how much;
what each payment was for, and when;
whether the money was general, research or an ownership stake.

How to read a record fairly

Check it is the right person. Many doctors share a name; match city, specialty and NPI.
Separate the kinds of money. Research funding usually supports a study and often goes to an institution. See the three kinds.
Look at what it was for. Twenty meals and one large consulting contract are different stories.
Compare within the specialty. Surgeons who develop devices are paid very differently from family doctors. Doctor pages show where someone sits among others in the same specialty.
Note the program year and any dispute. Records can be disputed and corrected.

What not to use it for

This information must not be used to decide someone's eligibility for credit, insurance, employment or housing: this site is not a consumer reporting agency and the record is not a consumer report. Using it to harass anyone, or presenting a payment as an allegation of misconduct, misrepresents what the record is.

If a payment makes you want to ask questions, the respectful route is to ask your doctor — see how to talk to your doctor about industry payments.