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Evaluation of Consulting Fee Payments and Conflict of Interest in Plastic Surgery and Related Specialties
Lesley Elizabeth Summerville BS ScM
Samuel Boas BS
Yida Cai BA
Brooke Wangler BS
Anand Kumar MD
Case Western Reserve University School of Medicine
2020-01-31
Presenter: Lesley Elizabeth Summerville
Affidavit:
Lesley Elizabeth Summerville
Director Name: Anand Kumar MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background:
The Physician Payments Sunshine Act (PPSA) is a disclosure program designed to increase transparency regarding physician and industry relationships. Consulting fees represent significant financial relationships between industry and physicians, with the potential to create conflicts of interest. The purpose of this study was to evaluate industry payments to plastic surgery and related specialties.
Methods:
This cross-sectional study used data access from the public CMS Open Payments Program database for the year 2018. Physicians practicing in dermatology, internal medicine, neurosurgery, orthopedic surgery, otolaryngology, and plastic surgery and related subspecialties were selected. Consulting payments were analyzed based on frequency, type, mean payment per specialty, and industry sponsors.
Results:
A total of 78,975 consulting payments were made to 17,554 physicians in these fields, totaling $250,518,240. Nearly half (47.7%) of physicians were paid at least $5,000 in consulting payment. Of these specialties, orthopedic surgeons (mean $27,229) and neurosurgeons (mean $17,941) were paid significantly more than other specialties (p<0.001). Plastic surgeons were paid a mean of $11,644, significantly more than otolaryngologists (p=0.01), but were not significantly different from dermatologists or internal medicine physicians. In plastic surgery, the largest industry contribution came from Musculoskeletal Transplant Foundation Inc., with payments totaling $514,719.
Conclusions:
This study showed disparities in consulting fee payments among specialties, with orthopedic surgery and neurosurgery receiving the largest payment amounts. This study noted that over 90% of payments were not associated with contextual information, potentially allowing conflict of interest. Further research is warranted to determine whether consulting payments impact patient or physician behavior.
