OBJECTIVES To characterize public perception of physicians' conflicts of interest (COIs) across medical and surgical specialties. PATIENTS AND METHODS A cross-sectional 6-arm randomized survey of a nonprobability sample from Amazon's Mechanical Turk occurred on December 11 to 16, 2018. Survey respondents were randomly assigned to vignettes that varied the physician specialty with COI. The primary outcome was mean difference in Mayer Trust, and the secondary outcome included the proportion who desire to discontinue care. RESULTS There were 1729 of 1920 respondents who completed the experiment (90.1% completion rate). Respondents were male (52.5%; n=907), white (71.4%; n=1234), and between the ages of 25 and 44 years (70.9%; n=1227). Mean ± SD Mayer Trust across the 6 specialties was 3.7±.60, with the only between-specialty differences observed for psychiatry compared with the other specialties (F=5.4; P<.001). The median dollar amount that would affect respondents' trust in a physician was $5000 (interquartile range, $100-$100,000). A total of 75.1% (n=1298) of respondents desired COI information, with 41.6% (n=720) discontinuing care. Age older than 34 years (adjusted odds ratio [aOR], 0.7; 95%, CI, 0.49-0.99; P=.047), nonwhite race (aOR, 1.3; 95% CI, 1.02-1.6; P=.03), educational attainment of 4 or more years of college (aOR, 1.31; 95% CI, 1.05-1.6; P=.016), and physician specialty as a psychiatrist (aOR, 1.5; 95% CI, 1.03-2.2; P=.034) were predictors for discontinuing care. CONCLUSION Public COI disclosure is a common method for managing financial conflicts. Although survey respondents were more likely to discontinue care with a physician with COI, they will act on this knowledge of COI differently depending on the specialty of the physician. The finding that psychiatry is an outlier may be a chance finding that warrants further confirmation. Continued efforts to ensure best practices for disclosure are required.

中文翻译：

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具有财务利益冲突的医师之间的公共信任与提供者专业之间的关联。

目的表征公众对医学和外科专科医师的利益冲突（COI）的看法。患者和方法于2018年12月11日至16日对来自亚马逊Mechanical Turk的非概率样本进行了6臂横断面随机调查。调查对象被随机分配到使用COI改变医师专长的小插图。主要结局是Mayer Trust的平均差异，次要结局包括希望中止护理的比例。结果1920名受访者中有1729名完成了实验（完成率为90.1％）。受访者为男性（52.5％； n = 907），白人（71.4％； n = 1234），年龄在25至44岁之间（70.9％； n = 1227）。6个专业的均值±SD Mayer信任度为3.7±.60，与其他专业相比，精神病学的唯一专业差异是唯一的（F = 5.4； P <.001）。中位数会影响受访者对医生信任的美元金额为$ 5000（四分位数范围为$ 100- $ 100,000）。共有75.1％（n = 1298）的调查对象希望获得COI信息，其中41.6％（n = 720）的患者需要中止护理。超过34岁的年龄（调整后的赔率[aOR]，0.7； 95％，CI，0.49-0.99； P = .047），非白人（aOR，1.3； 95％CI，1.02-1.6； P = .03） ，具有4年或以上大学学历（aOR，1.31； 95％CI，1.05-1.6； P = .016），以及作为精神科医生的医师专长（aOR，1.5； 95％CI，1.03-2.2； P = .034）是终止护理的预测指标。结论公开COI披露是管理财务冲突的常用方法。尽管受访者更有可能终止COI医师的护理，但根据医师的专业知识，他们对COI的了解会有所不同。精神病学是异常值的发现可能是需要进一步确认的偶然发现。需要继续努力以确保公开的最佳做法。