The intention of the Physician Payments Sunshine Act (PPSA) was to bring transparency to the financial payments that health care clinicians receive from the medical industry.1 The act’s leading proponents, Sens Chuck Grassley (Iowa) and Herb Kohl (Wisconsin), hoped that the public disclosure of industry payments to physicians would ultimately lead to lower health care costs. That result was to come from informed patients discussing with their physicians the physicians’ relationships with the medical industry. In turn, the scrutiny would make physicians reluctant to have those relationships, thereby reducing the medical industry’s influence on the prescription of high-cost medications.