BACKGROUND CONTEXT The prevalence of orthopedic surgeon-industry relationships and other physician-industry relationships led to the establishment of a national database of physician-industry interaction (the open-payments database, OPD) as part of the Physician Payments Sunshine Act (PPSA). While the transparency afforded by the PPSA is laudable, it raises questions about how these disclosures might impact patient-perceptions of their surgeon. PURPOSE To determine patient awareness of the OPD, patient awareness of their surgeon's industry relationships, how these relationships affect patient perceptions of their surgeon and which relationships caused the greatest concern to patients. STUDY DESIGN/SETTING Cross sectional study. PATIENT SAMPLE Two hundred patients. OUTCOME MEASURES Patient perceptions of surgeon-industry relationships. METHODS A 10-question survey was administered to patients prior to their first clinical evaluation with a spine surgeon. Two questions asked about patient awareness of their surgeon's industry relationships and their awareness of the OPD. One question evaluated the importance of surgeon-industry relationships to patients when choosing a provider. Six questions assessed patient perception of specific types of surgeon-industry relationships. The last survey question asked each patient to rank specific types of surgeon-industry relationships (1 = most concerning to 6 = least or not concerning). Descriptive statistics are reported. The distribution of patient-perceptions was compared using a Friedman's Two-Way Analysis of Variance by Ranks test. Distributions across awareness were compared using a Kruskal-Wallis Test. RESULTS A total of 200 patients completed the survey and were included in this analysis. The average age of patients surveyed was 48years (range: 16–89 years) with 45.0% (n=90) male patients. Most patients surveyed were Caucasian (80.5%) and had private health insurance (88.0%). A majority of patients were unaware of their physicians’ relationships with industry (89.2%) and the existence of the OPD (91.2%). Most patients (54.4%) considered surgeon-industry relationships an important, very important or most important part of choosing their physician. There were significant differences in how industry relationships affected patient perceptions. Research funding had the most positive impact on perception (47.8% very positive). Physician ownership share or stock ownership was most likely to negatively impact perception of surgeons (23.4% somewhat negative) while 73.1% of patients still reported that physician ownership had no effect or a positive impact on their perception of their surgeon. Awareness of the OPD or physician relationships did not have a significant impact on patient perception. Amongst all relationships, financial ownership was reported to be most concerning (2.92±1.99) followed by royalty payments (3.29±1.77) and consulting (3.61±1.46). Research, funding, industry sponsored dinners and speaking engagements were all scored similarly. CONCLUSIONS Our results suggest that most patients consider surgeon-industry relationships an important factor in choosing their doctor. Additionally, patients generally report a more positive view of surgeons who have active relationships with industry. These results emphasize the value of disclosure for surgeons; it provides transparency and improves their standing amongst a majority of their patients.