Journal
BMJ OPEN
Volume 9, Issue 9, Pages -Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/bmjopen-2019-031010
Keywords
open payments; physician compare; physician characteristics; medicare beneficiaries
Categories
Funding
- Burroughs Wellcome Fund Interschool Training Program in Chronic Diseases (BWF-CHIP)
- Fellowship in Epidemiology at UCLA
- Heiwa Nakajima Foundation
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Objective To investigate the association between physician characteristics and the value of industry payments. Design Observational study. Setting and participants Using the 2015-2017 Open Payments reports of industry payments linked to the Physician Compare database, we examined the association between physician characteristics (physician sex, years in practice, medical school attended and specialty) and the industry payment value, adjusting for other physician characteristic and institution fixed effects (effectively comparing physicians practicing at the same institution). Main outcome measures Our primary outcome was the value of total industry payments to physicians including (1) general payments (all forms of payments other than those classified for research purpose, eg, consulting fees, food, beverage), (2) research payments (payments for research endeavours under a written contract or protocol) and (3) ownership interests (eg, stock or stock options, bonds). We also investigated each category of payment separately. Results Of 544264 physicians treating Medicare beneficiaries, a total of $5.8 billion in industry payments were made to 365801 physicians during 2015-2017. The top 5% of physicians, by cumulative payments, accounted for 91% of industry payments. Within the same institution, male physicians, physicians with 21-30 years in practice and physicians who attended top 50 US medical schools (based on the research ranking) received higher industry payments. Across specialties, orthopaedic surgeons, neurosurgeons and endocrinologists received the highest payments. When we investigated individual types of payment, we found that orthopaedic surgeons received the highest general payments; haematologists/oncologists were the most likely to receive research payments and surgeons were the most likely to receive ownership interests compared with other types of physicians. Conclusions Industry payments to physicians were highly concentrated among a small number of physicians. Male sex, longer length of time in clinical practice, graduated from a top-ranked US medical school and practicing certain specialties, were independently associated with higher industry payments.
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