Disparities Among Industry’s Highly Compensated Orthopaedic Surgeons

Abstract

Background:The prosperous financial relationship between physicians and industry remains a highly scrutinized topic. Recently, a publicly available website was developed in conjunction with the U.S. Affordable Care Act to shed light on payments from industry to physicians with the goal of increasing transparency. The purpose of this study was to assess possible relationships between industry payments and orthopaedic surgeon gender, subspecialty training, and practice settings.Methods:A retrospective analysis was performed using publicly available information from the Centers for Medicare & Medicaid Services (CMS) to identify the 25 orthopaedic surgeons with the highest compensation from each of the 10 largest orthopaedic companies from 2013 to 2017. Statistical analyses were conducted to investigate the factors that contributed to payment differences.Results:Among the 347 highest-compensated orthopaedic surgeons, only 1 woman (0.29%) was identified. Orthopaedic surgeons in the subspecialties of spine (32.9%), adult reconstruction (27.9%), and sports medicine (14.5%) made up a majority of the 25 highest earners. A larger proportion of the physicians in this study worked in private practice (57.6%) compared with an academic setting (42.4%). Orthopaedic surgeons who subspecialize in sports medicine had significantly higher total mean payment amounts when compared with all other specialties. The primary method of compensation was found to be through licensing or royalty payments.Conclusions:The large majority of orthopaedic surgeons who are highly compensated from industry are men. Among these, the greatest number specialize in the spine, while sports medicine surgeons receive significantly higher total mean payment amounts. Additional studies are warranted to evaluate the disparities between men and women and encourage policies to promote gender equality.

Assessment of Medical Industry Compensation to US Physicians by Gender

“…Orthopedic surgery had the overall largest payment gap of $1 752 573, which is consistent with previous studies looking at the industry relationship with female and male orthopedic surgeons. 17,18 The study by Marshall et al 19 showed that the trend of industry payments was to direct larger payments to a reduced number of physicians, especially within medical and surgical subspecialties. This finding may explain the discrepancy in the male-dominated surgical specialties in our study because there were few women among the highest-earning recipients of industry payment in these fields.…”

“…The fields with the largest payment gaps, however, were male-dominated surgical fields: orthopedic surgery, urology, and neurosurgery. Orthopedic surgery had the overall largest payment gap of $1 752 573, which is consistent with previous studies looking at the industry relationship with female and male orthopedic surgeons . The study by Marshall et al showed that the trend of industry payments was to direct larger payments to a reduced number of physicians, especially within medical and surgical subspecialties.…”

Using a Modern Linked Research Database to Examine Gender Disparities in Orthopaedic Grant Funding from 2010 to 2022

“…It should also be noted that gender disparities in compensation have also been demonstrated in industry funding to orthopaedic surgeons. In a 2021 study by Robin et al, the authors studied the 347 highest-compensated orthopaedic surgeons, among whom only 1 woman was identified 30 . One hypothesis is that this difference in industry funding could have trickle-down effects that ultimately lead to differences in grant productivity, although this hypothesis could clearly not be examined utilizing our data and should be investigated further in future studies.…”

Developing Health Care Faculty to Address the Needs of North Carolina’s Diverse Populations

“…Further worsening of faculty shortages will threaten the nation's health professions educational infrastructure, and consequently exacerbate the existing health care workforce shortage and negatively impact health care outcomes [12]. Over the past two decades several factors have been identified to account for the widespread faculty shortages across multiple disciplines, including low level of interest in academic careers among those entering the health professions, the disparities in salaries between academia and private practice or industry, limited pool of qualified faculty who meet programmatic accreditors' criteria, aging of the faculty workforce, heavy faculty workloads, late points of entry into faculty careers, and lack of adequately qualified staff prepared to undertake the academic role [13][14][15][16][17].…”