Orthopaedic Surgeons Receive the Most Industry Payments to Physicians but Large Disparities are Seen in Sunshine Act Data

Abstract

Background Industry payments made to physicians by drug and device manufacturers or group purchasing organizations are now reported to the Centers for Medicare and Medicaid Services (CMS) as a part of the Physician Payments Sunshine Act. Initial reports from the program show that orthopaedic surgeons lead all physician specialties in total and average industry payments. However, before further discussion of these payments and their implications can take place, it remains to be seen whether these figures are a true reflection of the field of orthopaedic surgery in general, rather than the result of a few outlier physicians in the field. In addition, the nature and sources of these funds should be determined to better inform the national dialogue surrounding these payments.

Industry Payments to Obstetrician–Gynecologists

“…Similar disparities were seen in studies looking at 2013 payments to other surgical specialties, in which the top 1-10% of payment earners received between 69.5% and 95% of the total amount paid to the specialties studied. [9][10][11][12]14 According to recommendations by the College's Ethics Committee, physicians receiving substantial sums of money from medical industry have a particular obligation to their patients to disclose these transactions and to discuss their effect on clinical decision-making. 3 The College did not quantify the term "substantial" in their recommendations.…”

“…9,12 As a result of payment discrepancies related to legislative loopholes in reporting practices afforded to manufacturers, 62% of the total value transferred in 2013, $2.3 billion, was posted as deidentified. 7 The omission of individual identification from a significant fraction of 2013 payments undermined perceptions of transparency and reliability.…”

“…The terms searched included "open payments," "industry payments," "sunshine act," "open payments and OBGYN," "industry payments and OBGYN," "open payments and obstetrics," "open payments and obstetrics and gynecology," "industry payments and obstetrics and gynecology." Since the first publication of payment data, a few studies have objectively assessed industry payments to other surgical specialties, [9][10][11][12] but no studies have evaluated payments made in 2014 to ob-gyns, since they were made publically available on 6/30/2015.…”

Editorial: Is It Time to End Surgeon-Industry Consulting?

“…1 , Jonathan N. Grauer MD and colleagues from Yale University [15] provide the first analysis of commercial payments to orthopaedic surgeons released under the new disclosure rules mandated in 2013 by the Physician Payments Sunshine Act. Grauer and colleagues show that a small number of orthopaedic surgeons receive most of the money that flows from commercial sources [15].…”

“…Grauer and colleagues show that a small number of orthopaedic surgeons receive most of the money that flows from commercial sources [15]. A substantial portion of that money was paid as industry gifts to surgeons and consulting deals.…”