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Distribution, characteristics of industry payments varied among specialties
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During the first half-year of reports for CMS’ Open Payments program, researchers found a wide variation of distribution and characteristics of industry payments to physicians among specialties.
In their retrospective analysis, researchers searched the most recent publically available release of Open Payments data on industry payments to identified physicians that were made between August 2013 and December 2013. Researchers compared payments between specialty types and across specialties within each type, as well as the number of physicians who received payments with the total number of active physicians in each specialty in 2012. Physician ownership interest also were analyzed, according to the study.
Overall, researchers found 4.4 million payments totaling $2.6 billion reported to Open Payments. Results showed 2.43 million payments totaling $475 million were received by allopathic and osteopathic physicians. Although internal medicine and orthopedic surgery experienced the greatest total value, according to results, a greater number of internal medicine physicians received payment vs. orthopedic surgeons (77,515 vs. 15,459). Researchers noted cardiovascular disease and gastroenterology received the greatest number of payments.
Results showed general payments represented 90% of the total value of payments to allopathic and osteopathic physicians, and 10% as research payments. The highest median general payments were found in thoracic surgery, cardiovascular disease and urology. The highest mean value of general payments per physician were found in orthopedic surgery, neurosurgery and neurology.
Researchers found significant differences in the total dollar amount invested in a manufacturer, total values of interest in a manufacturer and the proportion of physicians with ownership interest among specialty types and by specialty within each type. Urology, neurosurgery and orthopedic surgery were most likely to have ownership interests with manufacturers, according to study results. – by Casey Tingle
Disclosures: Marshall reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
Perspective
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Jack M. Bert, MD
It is of interest that the scrutiny of industry payments to physicians has reached such an intense level. The ethical concerns regarding whether a physician uses a specific type of implant or medicine based upon his or her relationship with a company is usually obviated by the company's insistence that there is no royalty payment to that physician when used within his or her own private practice or institution. Without the input of highly skilled orthopedic surgeons, advanced technology techniques and implants would not be available. It is important for all orthopedic surgeons to be transparent with patients regarding success rates and survivorship using various products so our ethics remain unquestioned.
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